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THE POSTURE OF SCHOOL^CHILDREN 



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FrontinpLMd 



Gainsborough 



Plate I. — Portrait of J. Baillie of Ealing Grove, his Wife and 
Four Children. National Gallery, London. 



THE POSTURE 



OF 



SCHOOL CHILDREN 

WITH ITS HOME HYGIENE AND NEW 

EFFICIENCY METHODS FOR 

SCHOOL TRAINING 



BY 
JESSIE H. BANCROFT 

ASSISTANT DIRECTOR PHYSICAL TRAINING, PUBLIC SCHOOLS, NEW YORK CITY ; 

EX-SECRETARY AMERICAN PHYSICAL EDUCATION ASSOCIATION ; MEMBER 

AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE; 

AUTHOR OF "SCHOOL GYMNASTICS," "GAMES FOR THE 

PLAYGROUND, HOME, SCHOOL, AND GYMNASIUM," ETC. 



THE MACMILLAN COMPANY 

1913 

A/l rights reserved 



33 



Copyright, 1913, 

By the macmillan company. 

Set up and electrotyped. Published April, 1913. 



» • t 



J. S. Gushing Co. — Berwick & Smith Co. 
Norwood, Mass., U S.A. 






ZO 



THE CORPS OF SPECIAL ASSISTANTS 

% 

WHOSE STRENUOUS DEVOTION TO DUTY MADE POSSIBLE 
THE WORKING OUT OF THE EFFICIENCY METHODS 
HEREIN EXPLAINED, THIS BOOK IS APPRE- 
CIATIVELY AND AFFECTIONATELY 
INSCRIBED 



«_ with all hearts bowed in the strange control 

Of the heavenly voice of his violin, 
Why, it was music the way he stood, 

So grand was the poise of the head and so 

Full was the figure of majesty ! — 
One heard with the. eyes, as a deaf man would." 

— James Whitcomb Riley. 



PREFACE 

The term *' posture " is used in this book to denote the habit- 
ual carriage of the body, especially in the erect position. It 
involves the correct development and contours of spine, chest, 
shoulders, and other main segments, as well as their relation 
to each other in the upright position. 

Round shoulders and sunken chests are matters of concern 
to many a parent, and the development o^ X-ray photography 
has confirmed the far-reaching harm that may come to both 
children and adults through failure to achieve and hold the 
erect position. We now realize that many functional distur- 
bances, both acute and chronic, are traceable to the sag and 
displacement of organs due to poor posture, so that the carriage 
of one's head and shoulders may have as much influence upon 
digestion as the attitude of the chest upon the lungs. As a 
business and social asset, the position that discloses intelligence 
and energy can scarcely be overvalued, and its aesthetic power 
is obvious. Educators have long recognized that provision 
must be made in school programs for counteracting the detri- 
mental influence of school furniture and sedentary occupations 
on the postural development of pupils. 

To aid both home and school in these matters is the object 
of this book. Just what constitutes correct development and 
contours for posture at different ages, is a matter over which 
many a specialist has been puzzled, and the misconceptions 
that exist in the popular mind are widespread. How many 

vii 



viii PREFACE 

parents, for instance, know that a broad, flat chest is the proper 
type of development after the deep chest of very young child- 
hood ? or that the typical collapsed chest of the consumptive 
has, in most cases, too great a proportionate depth ? or that 
to train a child to "turn his toes out " is to invite falling arches 
and flat foot? 

It has seemed well to bring together in one volume the scat- 
tered material on these and related subjects, summarizing the 
right development of the entire body as related to posture. To 
this is added the home and school hygiene which has a constant 
molding influence on posture ; also the application of peda- 
gogical principles to the training of posture, and a working 
description of some new efficiency methods for schools. 

These efficiency methods consist of a combination of stand- 
ardized tests and group teaching worked out by the author 
during two years of special experimenting. In one year of 
general use they achieved remarkable results in upward of five 
thousand classes with 200,000 children. These methods are 
largely an application of some of the principles of the new 
school of efficiency engineers, or scientific management experts, 
— principles that are working a revolution in industrial circles 
and may do equally important service in education if the way 
can be found for applying them. One advantage of these 
methods is that they may be used to enhance the effectiveness 
of, without disturbing, other means that may already be in use 
for developing posture. 

Much of the material presented in this book was given by 
the author in lectures at Columbia University during several 
summer sessions beginning in 1901. The efficiency methods 
have been presented in many lectures during 1911-1912 to the 
public school force of New York City. In this book an espe- 
cial effort has been made to present the material in popular 



PREFACE ix 

form, but discussion of many technical points, of interest only 
to the specialist, is given in an Appendix. The bibliography 
indicates original sources and channels for further technical 
study of the subject. 

Physical training has grown widely in the last twenty years 
both in its subject matter and in the recognition accorded it in 
educational programs. That it is to have a still larger rec- 
ognition is abundantly evidenced by the widespread interest in 
public health, and the means taken to conserve it. The par- 
ticular need for schools lies not so much in finding new mate- 
rial or types of exercise, or in rearranging old material, as in 
discovering ways of getting better results from those in use. 
A course of study containing a large percentage of corrective 
exercises is only one part of the problem, as the improve- 
ment in standards of teaching from the use of these efficiency 
methods plainly indicates. 

Full efficiency in caring for the health of children will 
undoubtedly include better cooperation between the home and 
the school, and, through both of these channels, more time and 
opportunity for physical exercise. In schools there should also 
be much more expert assistance. Meanwhile, the tendency of 
schools to scatter energy over many types of exercise needs 
careful consideration if definite results in any one line are to be 
achieved. What with gymnastic exercise, — taken both with 
and without apparatus, — folk dancing, games, athletics, story 
gymnastics, mimetic exercises, and hygienic drills, all crowded 
into fifteen or twenty minutes a day, it is not surprising that 
quahty suffers at the expense of quantity. In short, the great 
need of physical training in schools to-day, aside from the ever 
present want for more time, is not so much the addition of new 
types of exercise, as new ways of getting and estimating results 
from those already in use — intensive work, not extensive. 



X PREFACE 

That this need can be met, and the standard of physical de- 
velopment raised, has been abundantly shown by the fact of 
literally thousands of children who in one year have, through 
the efficiency methods herein described, learned more definitely 
than ever before to stand, walk, and exercise in correct posture. 

JESSIE H. BANCROFT. 
June, 1912. 



TABLE OF CONTENTS 



I. Erect Carriage: its General Significance and Devel- 
opment IN THE Individual and the Race . 

II. How TO JUDGE OF CORRECT AND INCORRECT PoSTURE ; 

THE Vertical Line Test 

III. Some Mechanical Difficulties of the Erect Position 

IV. The Spine: (/) Antero-posterior Curves and their 

Faults 

V. The Spine: (//) Antero-posterior Curves, Contimied; 

their Effects on Trunk Capacity and Health 
VI. The Spine: (///) Lateral Curves . % . 

VII. The Head 

VIII. The Chest 

IX. The Shoulders . . . 

X. The Pelvis, Abdomen, and Feet 

XI. Posture in Adults' 

XII. Erect Posture in Sitting, Standing, Walking, and 
Stair Climbing . . . . . , . 

XIII. How TO CORRECT PoOR PoSTURE : WhAT MAY BE DONE 

AT Home ; training the Muscular Sense . 

XIV. How to correct PboR Posture: Home Exercise . 
XV. Home Hygiene of Posture; learning to Stand and 

Walk; Nutrition; Sleep and Sleeping Positions; 
Chairs and Tables; Weight Carrying; Music Prac- 
tice 

XVI. The Hygiene of Posture; Dress .... 
XVII. Efficiency Methods for School Training . 
XVIII. The Triple Test and Grouping for Posture 
XIX. Class Standards; Individual and Class Ratings 

Records 

XX. How TO correct Poor Posture in the Classroom 
training t;he Muscular Sense .... 



6 
i6 

27 

38 
47 
52 
61 

79 
92 

102 

III 

121 
132 



151 
167 

178. 
197 

204 

214 



Xll 



TABLE OF CONTENTS 



CHAPTER 

XXI. 



XXII. 
XXIII. 
XXIV. 

XXV. 

XXVI. 



how to correct poor posture in the classroom 
Corrective Exercise 

Summary of Efficiency Methods .... 

Auxiliary Aids . ...... . 

The School Hygiene of Posture .... 

Erect Posture as an Educational Aim . 

Erect Posture as an Expression of Intelligence and 
Character . . . . 



APPENDIX 

BIBLIOGRAPHY 

INDEX 



227 
238 
242 

253 
268 

275 

283 

309 
323 



THE POSTURE OF SCHOOL CHILDREN 



THE POSTURE OF SCHOOL 

CHILDREN 

WITH ITS HOME HYGIENE AND NEW EFFI- 
CIENCY METHODS FOR SCHOOL TRAINING 

CHAPTER I 

ERECT CARRIAGE; ITS GENERAL SIGNIFICANCE AND DEVELOP- 
MENT IN THE INDIVIDUAL AND THE RACE 

% 

The little child who has not frequently been admonished to 

''Sit up ! sit up straight and hold your shoulders back/' is both 
rare and fortunate. Round shoulders, protruding head, and 
sunken chest are so often met with in our boys and girls that it 
is not surprising so many grown people have never learned even 
the feeling of standing at their full height. 

Gro wing-up is not an easy task ; nearly every power of body, 
mind, and character, has to be trained and guided to mature 
expression ; but of all these weak and undeveloped powers none 
is in need of greater help than that of erect carriage of the body. 
It is a power lacking entirely at birth, and is acquired in a 
rudimentary way very slowly in the first two years of life. It 
usually fluctuates greatly during the years of growth, when 
bodily proportions and muscular strength change rapidly ; and at 
all ages the erect position has to be relieved by sitting and lying 
a large proportion of the time. If a fully erect carriage be 
achieved by the adult, it serves always as a sensitive barometer 
of fatigue or illness, and, finally, when old age comes, lessened 



2 THE POSTURE OF SCHOOL CHILDREN 

physical vigor and anatomical changes show in the proverbial 
stoop of advancing years. 

Why should we stand in good posture ? If one cares to sacri- 
fice the pride of appearance, is there any other consideration 
that makes erect carriage of the body desirable or necessary? 
The answer is threefold and most emphatic : erect carriage of 
the body is necessary (i) for full vigor and health ; (2) to prevent 
waste of energy in maintaining the upright position in any of the 
activities of life; and (3) with children, to admit of proper 
growth and development. To make plainer what is meant by 
each of these three points, it may be stated at once that only in 
the perfectly erect position of the body are the great organs of 
the trunk — heart, lungs, stomach, liver, kidneys, and other 
viscera that constitute the main working machinery of the body 
— in a position to perform their work to the best advantage. 
One may shift and change the posture temporarily with a great 
deal of positive benefit; indeed, activity in work, gymnastic 
exercise, or sport is necessary to health ; but the habitual bad 
carriage of the body in walking, standing, or sitting, or a faulty 
relation of its parts in habitual occupations (as in bending with 
a cramped chest over a desk or over sewing for many hours a 
day), may interfere seriously with the great functions of circu- 
lation, respiration, digestion, elimination, etc. 

For these functions to work at such a disadvantage is, of 
itself, a waste of energy ; and in addition to this, the expendi- 
ture of nervous and muscular effort required to maintain an 
incorrect standing position is greater than that necessary 
for a good position. The mechanical difficulties of the erect 
standing position should be appreciated. The body is an upright 
column, but one that is broken with joints at many points — at 
the ankles, knees, hips, throughout the entire length of the spine 



ERECT CARRIAGE; ITS GENERAL SIGNIFICANCE 3 

with its twenty-four separate vertebrae, and where the head is 
set on the spine. Around each of these joints are muscles and 
Hgaments that help to maintain the different parts, one upon 
another. In a perfectly poised standing position, the different 
parts or segments are so balanced that comparatively slight 
effort is necessary to maintain the position. In a poor standing 
posture, on the contrary, an unnatural strain is thrown upon 
muscles and ligaments, and though the stimulus for this strain 
may be supplied by unconscious nerve centers, the waste of 
energy and the general lowering of tone and efficiency in the 
organism are none the less real. Fatigue comes more readily, 
inertia is apt to be more apparent, and the general sense of 
well-being is lessened. Moreover, with this lowered tone of the 
organism the power of resistance to disease i? decreased. The 
germs of tuberculosis and other infectious and contagious 
diseases will find lodgment and will flourish in a body whose 
general tone and power are thus reduced, as they could not in 
one whose machinery is working to better advantage. 

To children these general considerations apply as forcibly as to 
adults, but assume an especial importance, since the great physio- 
logical functions have in childhood not only to provide for the 
waste and repair of daily usage, but must furnish also material 
and energy for growth and development. Moreover, — and this 
is of crucial importance, — the posture of the spine, chest, and 
shoulders throughout the growing period influences profoundly 
their ultimate contours and proportions. A well-developed 
chest, a back strong and normal in its growth, and shoulders 
and head well poised, are points of development that must be 
held of fundamental importance by every one concerned in the 
well-being of a little child. 

This erect carriage, so important for the conservation of health, 



4 THE POSTURE OF SCHOOL CHILDREN 

» 
energy, and growth, is one of the marked characteristics that 

differentiate the human race from lower animals. Man alone 
achieves the erect position, and his acquirement of it is accepted 
by anatomists and anthropologists as plainly an evolution from 
the position of the quadruped. The human spinal column, for 
instance, is looked upon as ''the quadrupedal spine set on end," 
and no other theory can account for many peculiarities incident 
to the erect position. For example, the Hgaments that support 
some of the organs are far better adapted to holding them in 
position when the spine, to which they are attached, is horizontal, 
than when it is upright. Again, the lack of valves in many of 
the veins is not the detriment to circulation of the blood in a 
horizontal position that it is in an upright attitude. These and 
other disadvantages due to the erect position serve to make clear 
the need for cultivating that perfect balance in which the great 
physiological functions are performed to the best advantage.^ 

Offsetting these disadvantages of the erect position are certain 
very marked benefits conferred by it without which the hu- 
man race could never have become what it is. Foremost among 
these is the mechanical advantage which the position gives for 
use of the hand and arm in the industries that are at the base of 
civilization. 

" In the swinging of the scythe, man instinctively avails himself of 
the easiest mode of supporting the center of gravity during labor, 
and that is, the rotary. Man rotates about a vertical axis in nearly 
every act of labor. The carpenter planing or sawing, the black- 
smith, and the miner, are all illustrations of rotary motion, the result 
of the universal practice of working over one shoulder, which necessi- 
tates a twist. . . . Rotary motion in the erect position requires 

1 Clevenger, No. 20 of Bibliography appended to this volume ; Baker, 3 ; Ellis, 
35 ; Lovett, 86. 

See Appendix, Note i. 



ERECT CARRIAGE ; ITS GENERAL SIGNIFICANCE 5 

that one hand should be the principal and one the assistant. . . . One 
of the reasons why man prefers to use one arm [chiefly] at a time 
is, that either arm has freer motion when used alone than when both 
are used together. Man can reach farther in every direction with a 
single arm than with both." ^ 

The relation of erect posture to intelligence and brain de- 
velopment is marked and of great interest. The acquirement of 
the upright position by the race has been coincident with the 
development of the higher brain, the cerebrum, and it is cer- 
tainly not an accident that this position, which admits of a far 
greater range and variety of movements than any other, should 
have developed with the nerve centers that inaugurate, direct, 
and control new movements. In an extended discussion of the 
relation of brain evolution to erect posture* Dr. Ross maintains 
that the erect position could not have been acquired without 
this cerebral development, and says, ''The degree of intelligence 
to which an animal has attained is measured by its capacity 
of effecting multitudinous changes of attitude." ^ 

Applying this principle to an unfortunate class of human 
beings, it will be recalled at once that among the most marked 
characteristics of idiots and mental defectives are their collapsed 
posture and imperfect carriage, their slouching gait, in extreme 
cases their inability even to stand erect, and their undeveloped 
capacity for movement, which is often limited to the monotonous, 
automatic repetition of a few actions.^ 

The man, then, who can draw himself to the full height of a 
perfectly erect carriage, may well be said to typify in that act, 
not only a condition for the greatest health and efficiency of 
the individual, but the long climb upward of the race, through 
the interaction of movement and intelligence, to all that is im- 
plied in the phrase "the full stature of man." 

^ Allis, 2. 2 g^Qss^ jjy. Huxley, 153. ^Johnson, 76; Trettien, 138. 



CHAPTER II 

HOW TO JUDGE OF CORRECT AND INCORRECT POSTURE ; 
THE VERTICAL LINE TEST 

The young girl in the accompanying illustration (Fig. i) 
is standing in a perfectly erect attitude. The long axis or 
diameter of the trunk of the body is a perfectly vertical line; 
the long axis of the neck and head taken together is also 
a vertical line. To assist the eye in determining these points, a 
line may be dropped from the front of the ear to the forward 
part of the foot ; it will be seen to parallel the axes of these large 
segments of the body, and at the same time will serve to show 
that the weight is perfectly balanced in relation to the feet. In 
poor posture the axes of these main segments of the body (neck 
and head, and trunk), instead of forming one continuous, vertical 
line, are broken into two or three zigzag lines, as explained in 
connection with Fig. 2. 

This is the vertical line test. It serves for estimating the 
poise of the entire body except the shoulders. The shoulder 
blades should lie fiat on the back, but as the clothing may con- 
ceal their position, extreme cases of forward or round shoulders 
may be judged by the relation between the shoulder tip and the 
ear. If the neck be erect, the middle of the round or tip of the 
shoulder should lie back of the forward border of the ear. This 
may be called the ear test for the shoulders. 

The effect of ease and buoyancy that this standing position 
gives is by no means deceptive, for in such posture, and in it 

6 




Plate II. — Melpomene. Florence. 



CORRECT AND INCORRECT POSTURE 9 

alone, does every organ of the body have full opportunity for its 
work. In this position, also, the girl is at her full height, and 

the different parts of the body 
are so poised that the least 
amount of nervous and mus- 
cular energy is needed to keep 
her in the upright position. 





Fig. I. — A perfectly erect attitude. 

This vertical line test for 
erect posture of the body as a 
whole is equally applicable to 
children of all ages and to 
adults. It forms the simplest 
means of determining good carriage, for in this way one sees the 
whole figure at a glance, and analytical details appear, as they 
should, in relation to the whole, and not as detached facts.^ 



Fig. 2. — Incorrect posture : the " fa- 
tigue position." 



Appendix, Note 2. 



lO 



THE POSTURE OF SCHOOL CHILDREN 



Bad posture, as already intimated, may also be determined 
by the use of a line test, but in all types of bad posture the 
line indicating the general axis of the body becomes a zigzag 
instead of vertical. For practical educational purposes there 

are four types of bad 
posture that need to 
be considered.^ The 
commonest of these is 
called the fatigue posi- 
tion, because, though 
unfortunately the ha- 
bitual carriage of some 
people, it is the col- 
lapsed or relaxed posi- 
tion that any one is 
liable to assume tem- 
porarily when fatigued. 
In the fatigue posi- 
tion (Fig. 2) the neck 
and head droop for- 
ward, and the upper 
part of the trunk sinks 
backward, so that a 
straight line indicating 
the axis of the head, 
neck, and upper back 
slopes downward and backward to the region of the shoulders 
instead of being vertical; the axis of the lower trunk joins 
this upper line at an angle and slopes in the opposite direc- 
tion — downward and forward to the hips; a line from this 

1 See Appendix, Note 3. 




Figs. 3-4. — The vertical line test made by holding a 
window pole beside a pupil : poor posture and its 
correction. 



CORRECT AND INCORRECT POSTURE 



II 



rf- 



point to the forward part of the foot would mean still another 
angle, following a third direction. There are thus, in this fatigue 
position, three distinct lines indicating the axes of the three 
main divisions of the body, instead of one 
continuous, vertical line as in the perfectly 
erect standing position. The faulty position 

and its correction are com- 
pared with a vertical line 

in Figs. 3 and 4. 

The second of the four 

types of bad posture is 

one in which the lower part 

of the back is straight. 

The natural inward curve 

of the spine at the "small 

of the back" is obliterated, 

and the back is straight or 

even bowed outward at this 

\\ 1 point (Figs. 5, 6). Accom- 
I ' panying this straight lower 
' back, the line of the neck 

and head protrudes for- 
ward as in the fatigue posi- 
tion. This posture is one 
of the most harmful, but 
as a standing position is 
less frequently found among 
adults than the fatigue position. It is also rare as a standing 
position among children, although they cultivate it industriously 
as a sitting posture. 

The third of the four types of bad posture is, in some respects, 




Fig. 5. — The second 
type of bad posture, 
with the lumbar curve 
(iiatural hollow in 
the back) obliterated. 
{Outline drawing from 
photograph of a woman 
by Goldthwait.) 



Fig. 6. —The obliter- 
ated lumbar curve 
in a man. {Outline 
drawing from pho- 
tograph by Gold- 
thwait.) 



12 



THE POSTURE OF SCHOOL CHILDREN . 



entirely different from the first two, being induced by overexer- 
tion, rather than by relaxation, as are the fatigue and fiat-back 
positions. It comes from a mistaken effort to lift and expand the 
chest, which throws the region of the stomach and chest ridic- 
ulously forward and 
upward, like that of a 
bantam or of a pouter 
pigeon (Fig. 7). The 
upper part of the 
spine is overextended, 
so that it leans back- 
ward and forms a 
marked exaggeration 
of the natural curve 
in the small of the 
back (lumbar region), 
■ — ^an exaggeration 
that is known tech- 
nically as lordosis. 
This bantam position 
is not one that a child 
is apt to assume of 
himself; it comes al- 
most invariably from 
a mistaken effort on 
his part to ^'make 
himself tall," or otherwise to get into a good position, — an 
effort that is often induced by unwise admonitions from his elders. 
The position is common among very young children and comes 
from making an effort for good posture before they have acquired 
the muscular control that is necessary for shifting the position of 




Fig. 7. 



Overcorrected posture; the "bantam" 
attitude. 



CORRECT AND INCORRECT POSTURE 13 

different parts of the body. It is also found a great deal among 
older children until they and their instructors learn the difference 
between a correct and an exaggerated posture. In the case of 
adults the position seems to be acquired instinctively by portly 
people in an effort to balance the weight of the front of the 
body by throwing backward the upper part. The position is also 
assumed in some cases from a mistaken idea as to what consti- 
tutes a good chest. This bantam position is so easily discerned, 
being usually accompanied by stiffness and effort, that no par- 
ticular criteria are needed for judging it. To guard against it in 
children, where it does the most harm, one should be watchful 
for the extreme hollow in the back, as well as for the lifting too 
high in front of the chest or breast bone (sternum). 

It will be noticed that in all three types of poor posture just 
described, the faults are those that carry some part or parts 
of the body too far backward or forward, as head thrust forward, 
upper spine carried backward, etc. These are called technically 
antero-posterior deviations from the normal standing position, 
and may most readily be discerned by looking at the subject 
from the side or in profile. The fourth type of postural defects 
is most readily seen by observing the subject from the front 
or back. These are the one-sided or lateral deviations, of which 
lateral curvature of the spine, or scoliosis, is the condition most 
often indicated, and for which one should be most watchful. 
This condition may usually be discovered through the facts that 
one shoulder is lower than the other, that the head is carried on 
one side, that there is a tip, or yielding of the shoulders to one 
side habitually in standing or walking, or that the hips are of 
uneven height (Fig. 8). These faults may, or may not, indi- 
cate curvature of the spine. If that condition exist, further 
means for detecting it are available, To trace the line of the 



14 



THE POSTURE OF SCHOOL CHILDREN 



spine itself down the middle of the back with the finger, may 
disclose a curve to one side ; or one shoulder blade may be found 
more prominent than the other, — an indication of rotation of 
the spine that often accompanies curvature. Wherever any 
of these one-sided faults of carriage is found, however, there 
should be a closer examination by a medical or physical training 

specialist. It is not for a parent 
or teacher or any layman to de- 
termine whether or not a genuine 
case of scoliosis exists, and no one 
but a physician may properly de- 
termine how serious it may be. 
All possible means should be 
taken to secure proper diagnosis 
and treatment for such a con- 
dition, or to prevent its develop- 
ment if it be incipient. 

The extent to which bad pos- 
ture may be observed among 
adults is astonishing when one 
learns to recognize it, though we 
have no figures that give the ex- 
act proportion of bad to good 
posture among them. Of chil- 
dren, it is safe to assert that with- 
out special training not more 
than forty per cent stand correctly, — a liberal estimate, — fifty 
or fifty-five per cent having antero-posterior faults, and the other 
five or ten per cent having lateral deviations. This estimate of 
antero-posterior cases is based on studies made by the author 
in schools and other public and private institutions of New 




Fig. 8. 



Indications of lateral curva- 
ture of the spine. 



CORRECT AND INCORRECT POSTURE 15 

York and other cities before the efficiency methods herein 
described were used.^ 

Lateral deviations of posture, involving the spine, have always 
been recognized as pathological and have received a large amount 
of attention from the medical profession. Antero-posterior 
deviations, while always regarded as undesirable, have been 
more slowly recognized as a factor in pathological conditions. 
Physical trainers, as a rule, have always worked for correct 
posture as one of the main features of a good physique, and there 
has been quite general recognition of the necessity for definite 
provision for postural training in school curricula. In the medical 
profession, recent research with the X ray and otherwise (in 
disclosure of the extent of displacement of the abdominal organs 
through antero-posterior faults of posture, and the consequent 
interference with the functions of those organs) has placed such 
posture at once, more strongly than ever, among the serious 
conditions to be reckoned with in bodily health and efficiency. 

^ For statistics of lateral deviations, see Lovett, 86. 



CHAPTER III 

SOME MECHANICAL DIFFICULTIES OF THE ERECT POSITION 

An ingenious way of illustrating the muscular action necessary 
to keep erect the various segments of the body, is found in imag- 
ining the assumption of the erect position by a man on his hands 
and knees, or ''all fours." ^ 

Stated in largest terms, the leg is straightened upon the foot 
by muscles of the calf, the thigh is straightened upon the knee 
by muscles on the front of the thigh ; the trunk, where it joins 
the legs at the pelvis, or hips, is pulled up into position by the 
muscles on the buttocks and back of the thighs; the spine 
throughout its length is held upright by erector muscles on the 
back, and the head by muscles on the back and sides of the neck 
attached mainly to the back. It will be seen from this that with 
the exception of the knees, all of the muscles that pull the 
body into an upright position are on the back, called posterior 
muscles ; and these are precisely the ones that have most to do 
with maintaining the erect position when once acquired, for 
without their support the tendency of the body is to fall forward.^ 

When the different segments of the body — legs, thighs, 
trunk, and head — are balanced over one another in a well- 
poised standing or sitting position, the bones, and the ligaments 
that bind the joints together, do a large proportion of the work 
of maintaining the position, and the nervous and muscular en- 
ergy required of the posterior muscles is reduced to a minimum. 

1 Huxley, 153; Ross, 117. ^ Schafer, 159; Lovett, 86; Feiss, 37. 

16 




Plate III. — Girl with Goat. Dresden. 



DIFFICULTIES OF THE ERECT POSITION 19 

When these muscles are weak, or have never been trained to 
contract properly, the body droops forward in some of the atti- 
tudes of poor posture. Similarly, when there is a lessening of 
nervous energy from fatigue, illness, the nervous depression of 
worry, or from any other cause, these posterior muscles fail to 
contract properly because of insufficient nervous stimuli, and 
faulty posture is the result. 

Another continual demand upon the muscles in the erect 
position is made to keep the center of gravity of this column 
over a very small base of support, the feet. The center of gravity 
in the human body — that is, the point around which all of the 
rest exactly balances — is situated well forward in the region of 
the hips. Knowledge of the exact location o^ the center of grav- 
ity for living subjects has lacked scientific accuracy until very 
recently, when Drs. Lovett and Reynolds of Boston have de- 
vised a means for determining the center of gravity in any 
individual (Fig. 9). It is a specially contrived balance that 
enables the observer, through computation of the weight of aii 
individual with other points, to erect a vertical line through this 
point. ^ 

This balance shows that a vertical line drawn through the 
center of gravity passes in front of the ankle joints, in front of 
the knees, and in front of all of the vertebral column except 
possibly a little in the lumbar region. As shown in the accom- 
panying cut, this line through the center of gravity practically 
corresponds with the vertical line test for the erect position 
explained in a previous chapter. The exact location of the center 
of gravity must, of course, vary in different individuals, for the 
proportion of parts, and the amount of muscular and adipose 
tissue, are subject to great variations. 

1 Reynolds and Lovett, 115 ; Lovett, 86, 87. See Appendix, Note 4. 



20 



THE POSTURE OF SCHOOL CHILDREN 




Fig. g. — The Reynolds and Lovett apparatus for determining the center of gravity in 
the human body. The vertical Une is the perpendicular of the center of gravity 
which is near the level of the hip joint. (From Lovett' s ''Lateral Curvature of the 
spine and Round Shoulders:' Courtesy of Dr. Lovett, Messrs. P. Blakiston Son Sr Co., 
and Jr. Am. Med. Ass.) 



An architect, in designing a tower or column of any kind, gives 
an unconscious sense of security to the impression that it makes, 
by enlarging the base somewhat beyond the circumference of the 



DIFFICULTIES OF THE ERECT POSITION 21 

building above it. While this may not be structurally neces- 
sary to insure that the hne of gravity shall fall within the base, 
it satisfies a certain instinct for stability. When the human 
body is in the erect position with the feet together, the base of 
support is smaller in circumference than much of the column 
above it, — a fact that in itself shows how very difhcult equilibrium 
must be. The base may be enlarged by placing the feet in differ- 
ent positions, and the poet Goethe long ago pointed out that 
walking was a falKng forward, the foot being put forth in a step 
to enlarge the base of support and prevent a fall. 

The higher the center of gravity above the base, the more 
difficult equilibrium becomes, and it is probably not without 
significance that during the growing years ^f childhood, when 
posture is most apt to go astray and when it most needs training 
and help, the center of gravity is being rapidly lifted through the 
growth of the legs. Until about fifteen years of a child's age, 
the legs grow more rapidly than the trunk. Stated in figures, 
during the first three years the legs grow proportionately one 
third more than the trunk; from the third to the sixth year 
of age they grow almost half again as fast as the trunk ; from the 
sixth to the ninth year the legs grow proportionately three 
fourths more than the trunk ; and from the twelfth to the fifteenth 
more than half as much. After the fifteenth year the trunk 
grows faster than the legs.^ 

The difference in the proportionate height of the center of 
gravity in a little child and an adult is well indicated in Fig. lo. 
Although the center of gravity is not marked on these figures, it 
is located in the lower part of the trunk in each case. 

1 The best summaries of heights are to be found in Burke, 15 ; and the study 
of relative growth of trunk and legs (from which the figures in the text are inter- 
preted) in Tyler, 140. The original sources include Liharzik, Key, Bowditch, Por- 
ter, Hastings, and, indeed, practically the entire bibliography on growth of children. 



22 



THE POSTURE OF SCHOOL CHILDREN 



The proportionate height of the center of gravity above the 
base of support may, then, be considered one of the mechanical 
difficulties of erect posture at all ages, but especially during the 
growing period, when a rapid change in height is taking place. 




Fig. io. — Diagram showing relative proportions of child and adult {.after Langer). 

Another demand made by the erect position upon the muscular 
system is to keep the center of gravity over the base of support, 
and this is not always done by changing the position of the feet 
as in walking. If one part of the body, say the trunk, be bent 
forward at the hips, the body will topple over, unless some 
other part, the thighs, be thrown correspondingly in an opposite 



DIFFICULTIES OF THE ERECT POSITION 



23 



direction, to counterbalance the weight (Fig. 11). This in- 
stinctive shifting of balance, while one of the most useful pro- 
pensities of the human mechanism, is nevertheless responsible 
for some of the worst faults of posture. For instance, if the 
weight of the head, instead of being perfectly balanced on the 
spine, be allowed to droop forward, some other part, usually 





Fig. II. — Diagrams showing the mechanical reactions of the body whereby the center 
of gravity is kept over the feet. The center of gravity is indicated by a dot ; in the 
third figure it is outside the body entirely. {Adapted from Schdjer; center of gravity 
placed according to Lovett and Reynolds.) 

the upper part of the trunk, will sink correspondingly backward 
to keep the weight equally balanced around the center of gravity. 
The same thing happens if the shoulders be so far forward that 
the weight of the arms falls in front of a balanced position ; the 
back, carrying the chest downward and backward with it, will 
then round out to equalize the distribution of weight. The 
same mechanical principle applies to one-sided effects. 



24 THE POSTURE OF SCHOOL CHILDREN 

It will be seen that in many ways gravitation is a constant 
force to be resisted in maintaining erect posture. Dr. Sargent 
graphically sums this up in the following paragraph : 

"From the time a child leaves its mother's arms and begins to 
stand and walk alone, there is a force with which it, in common with 
the rest of mankind, is always contending; this force is gravity. 
We are battling with this force from morning till night, yield- 
ing to it partially as opportunity offers to assume a sitting posi- 
tion, and finally yielding to it completely, as we do each night 
when we sink to rest in a horizontal position. But this force 
not only acts upon the body as a whole throughout the day, 
but upon each individual part of the body. Thus the head tends to 
drop forward, the shoulders to round over and droop forward, the 
back to curve, the chest to become flattened and compressed, the 
knees to bend, the arch of the foot to break down, etc. This is nature's 
attempt to seek an equilibrium . . . and the only way that this 
downward tendency can be overcome is by the constant exertion of 
muscular force." ^ 

In walking or any other activity of the body, this instinctive 
mechanical reaction is always present. In this connection, 
notice the undulating movement which the artist has caught in 
the walk of the Greek girl shown in Plate III. 

It is apparent that in erect posture no one part of the body 
can be considered alone. Head, chest, shoulders, spine, pelvis, 
and feet, in order to preserve a mechanical balance, if for no other 
reason, are so interrelated that any change in the position of 
one is accompanied by changes in the others. It therefore 
becomes important to know just what constitutes the correct con- 
tours, development, and carriage of these different parts at differ- 
ent ages, as well as their general relation to each other, and these 
points will be considered separately in succeeding chapters. 

^ Sargent, 122. 




Plate IV. — Infant Bacchus. 



CHAPTER IV 
THE SPINE, /: ANTEROPOSTERIOR CURVES AND THEIR FAULTS 

The spinal column, or spine, is of fundamental importance in 
any consideration of posture, for aside from changes in its own 
position, it influences, more than any other part of the body, 
the position of the organs of the trunk, or viscera, as well as other 
important bony sections that are attached to it, — the head, 
chest, and pelvis (Fig. 12). Moreover, through its many joints, 
the spine becomes especially sensitive to cha^iges in the position 
of other parts of the body, so that it is continually called upon 
to shift its curves to maintain the equilibrium. It is therefore 
not surprising that it should be involved in almost all faults of 
posture, and a primary object for attention in any effort at 
correction. 

The spine is made up of twenty-four separate bones — the 
vertebras — and a comparatively large, flat, and roughly trian- 
gular bone at the lower end called the sacrum. To the 
sacrum is attached the large bony rim (the pelvis), called 
"the floor to the trunk," of which the hips are a part. A 
very small bone beyond the sacrum (the coccyx) completes the 
spinal column, but is unimportant. 

In its normal, upright position the adult spine has several 
very pronounced curves from front to back (antero-posterior 
curves) that add to its flexibility, so that it yields to jar like 
a spring, preventing shock to the spinal cord within it. Its 
movement, or flexibility, is greatly increased by little elastic 
cushions or discs of cartilage between the vertebrae. These 

27 



28 



THE POSTURE OF SCHOOL CHILDREN 



discs are compressed and become temporarily thinner whenever 
the edges of the vertebrae above and below them are forced 
closer together in a bending movement. Indeed, these little 
cartilaginous discs have more to do with the natural or physio- 
logical curves of the spine than the bony vertebrae themselves, 
for it is mainly by means of their differing thickness at different 
points that the vertebrae are tilted to form these curves. With- 
out the discs the spine would lose not only 
much of its curving outline, but also much of 
its power to move or bend in any direction. 
In old age it is largely the permanent shrink- 
age of these cartilage discs that leads to a 
stooping posture. These little cushions or 
discs of cartilage are of very great importance 
in posture, because if they are compressed too 
much habitually in any one direction, instead 
of resuming their normal thickness when re- 
leased, they become molded to the new shape ; 
Fig. 12. — Spine, chest, there then comes a pressure on the bones 
^^^^^* (vertebrae) which may alter their structure, 

too, so that the spine may become permanently deformed, and 
unable to assume its proper position. This is what often hap- 
pens in lateral curvature of the spine, and it may occur also in 
the exaggerations of antero-posterior curves that are found in 
most poor posture. 

The vertebrae are numbered from above downward in three 
series, each series forming one of the natural antero-posterior 
curves of the spine (see Fig. 14). There are seven vertebrae in 
the neck, called cervical vertebrae, which form the cervical 
curve ; below these are twelve, to which the ribs are attached, 
called the dorsal or thoracic vertebrae, which form the dorsal 




THE SPINE 



29 



10. 
11., 



12. 



l^ 



5. 



Fig. 13. — View of the Fig. 14. — View of the 

spinal column from the spinal column from the 

j-ear. side, front to the left: 

C, cervical ; D, dorsal ; 

L, lumbar ; S, sacrum ; 

C, coccyx. 

curve — a curve which is largely overlaid by the shoulder blades ; 
and below these dorsal vertebrae are the last five, situated in the 
''hollow of the back," called the lumbar vertebrae, which form 



30 THE POSTURE OF SCHOOL CHILDREN 

the lumbar curve. Below this the outward curve of the sacrum 
in the region of the buttocks is sometimes called a fourth physi- 
ological curve in the spine. 

It will thus be seen that the cervical vertebrae, being in the 
neck, affect directly the position of the head ; the dorsal curve, 
having the ribs attached to it, has an immediate effect upon the 
chest, and the lumbar curve, being between the chest and the 
pelvis (hips), affects directly the position of both of those parts. 
This is not meant to imply that each of these curves does not 
affect other parts than those specified, but merely that its most 
direct effect is discernible in the position of the parts mentioned. 
The neck may best be considered in connection with the position 
of the head, and will be discussed in the chapter on the head ; 
the dorsal and lumbar curves are the subject of the present 
chapter. 

These two curves, the dorsal and lumbar, are the great of- 
fenders in posture. The lumbar curve is one of the most beauti- 
ful in the body (Fig. 15), and artists very often pose a figure so 
as to get the best view of this curve from the back or sides. 
Thus it is shown, slightly exaggerated by a transitory backward 
movement, in Plate XXV. As regards power to maintain its 
normal contours, the lumbar curve is, nevertheless, one of the 
weakest points of the spine. Its commonest fault is a failure 
to hold up the dorsal part of the spine or upper trunk, which 
it allows to sink backward and downward, so that both the dorsal 
and lumbar curves become exaggerated. Just what is meant 
by this sinking backward of the upper part of the trunk will 
be made clearer by reference to Figs. 3 and 4 in Chapter II. 
There it is shown that in the fatigue posture theiront outline of 
the upper chest is close to the vertical line ; in Fig. 4 (the corrected 
posture) the entire upper part of the trunk has been brought 



THE SPINE 



31 



forward so that the front of the chest is in advance of the vertical 
Hne. The lower part of the trunk, as shown in front by the 
belt, remains in the same relation to the vertical line in both 
pictures. In other words, the great 
fault in the relaxed type of incorrect 
posture, known as the fatigue posi- 
tion, is a sinking backward of the 
upper part of the trunk, due to r. 
yielding in the lumbar curve. Its 
correction is made by bringing the 
upper part of the trunk forward. 

The lumbar curve may also be 
exaggerated by the faults of posture 
that come from overdoing the effort 
for erect position. Thus, it may be 
exaggerated by an unnatural spring- 
ing backward of the hips and knees 
(see Fig. 36). This position, aside 
from the strain on the muscles and 
ligaments of the spine itself, is harm- 
ful in that it tends to withdraw the 
bony floor of the trunk by tilting the 
pelvis too high behind and too low 
in front, thus throwing an abnormal 
strain on muscles and ligaments. 
Similarly, in the exaggerated lifting 
of the chest shown in the ''bantam" 
attitude, the dorsal spine is tilted backward. It is a mis- 
take, however, to think that a throwing backward of the trunk 
in this forced attitude corrects the dorsal curve by straight- 
ening or reversing it, or that it renders the dorsal spine more 




Fig. 15. — The lumbar curve. 
Javanese Girl (Stratz). 



32 THE POSTURE OF SCHOOL CHILDREN 

flexible. Investigations on the mechanics of the spine have 
demonstrated that the dorsal curve cannot be straightened or 
reversed. When the trunk is tipped backward in this way, the 
movement "occurs almost wholly in the lumbar and lower two 
dorsal vertebrae." The dorsal curve above its lower two ver- 
tebrae tips backward as a whole, practically retaining its natural 
outline with the concavity forward.^ 

" The dorsal region is the least mobile part of the spine as a 
whole. The twelfth dorsal vertebra from the point of view of 
function must be regarded as a lumbar vertebra and not as a part 
of the dorsal region. . . . Hyperextension as a general spinal 
movement is essentially a lumbar motion." ^ 

This exaggerated attitude, therefore, only serves to intensify 
the lumbar curve. Such exaggeration of the lumbar curve 
is called technically lordosis, and exaggeration of the dorsal 
curve kyphosis. The weakness of the lumbar curve is accounted 
for in several ways. Although the lumbar vertebrae are larger 
than any other in the spine, and some of the strongest 
muscles are attached to them, it has been suggested that 
this point is a dividing line for the insertion and origin 
respectively of certain large upper and lower groups of mus- 
cles (psoas below and trapezius above) , — a fact that may 
lead to easy yielding at that point. ^ Moreover, at the level 
of the lower lumbar vertebrae (fourth and fifth), the trunk 
of the body reaches its shallowest depth from front to rear; 
immediately above this its size increases rapidly, containing 
the largest and heaviest of the viscera, — stomach, liver, kidneys, 
etc., — so that the weight and proportion of the trunk and its con- 
tents in the dorsal region favor any yielding to gravity in that 

^Lovett, 86, p. 25; Englehard, quoted, ibid., p. 33; Feiss, 37. 
2Lovett, 86. aLovett, 86, p. II. 



THE SPINE 33 

part.^ Again, the lumbar region has a greater fiexibiHty and 
range of movement than any other part of the spine except the 
neck, and this very facihty may be another cause of weakness. 
With the sinking backward of the dorsal spine, the head is almost 
invariably protruded forward, — an unconscious effort for me- 
chanical balance undoubtedly being a factor in the position of 
the head. 

However it be accounted for, the fact remains that an exag- 
geration of the dorsal and lumbar curves, through a sinking 
backward of the upper part of the trunk, is the chief fault in a 
large percentage of cases of poor posture and is invariably present 
in the fatigue position. This fact may be easily detected in the 
contours of the body in various ways, but th^ slanting, instead 
of vertical, direction of the axis of the trunk is the most obvious. 
The extreme hollow in the back is another point to note for the 
exaggeration of dorsal and lumbar curves. Seen from the front, 
as the dorsal curve (upper part of trunk) sinks backward and 
becomes more pronounced, the chest sinks downward and back- 
ward with it, for the attachment of the ribs to the dorsal spine 
is such that the position of one cannot be altered without affect- 
ing the other (Fig. i6). The abdomen also reflects this posi- 
tion of the back; its muscles become relaxed and fail to hold 
the viscera in place, so that the sag of these below, and the back- 
ward carriage of the trunk above, give the abdomen the ap- 
pearance of protruding forward.^ 

In the second type of relaxed posture described in Chapter II 
(Figs. 5 and 6) the lumbar curve is affected in just the opposite 
way; that is, instead of being exaggerated or intensified, it is 
practically obhterated, the back at that point being made flat 
by a bowing outward or reversal of the lumbar curve. The 

1 Goldthwait, 48 and 49. 2 Appendix, Note 5. 



34 



THE POSTURE OF SCHOOL CHILDREN 



immediate result of this position is to tip the rear edge of the 
pelvis downward, and tilt its front edge upward, so that it bears 
an entirely different relation to the trunk than is normal. In this 
position, the weight of the heavy abdominal viscera above the 
lumbar curve bears directly downward on the pelvic contents 
as it should not, for in the normal position the muscles on the 
front of the abdomen take a large part of this weight. 

The outline of the back in children appears very different 
at different ages, and the trained expert sees 
the development of the natural antero-pos- 
terior curves much earlier than they are dis- 
tinguished by the lay mind. Technically, 
the dorsal curve is present at birth, the 
cervical curve is said to appear when the 
head is first held up, and the lumbar curve 
appears when the legs are straightened in line 
with the spine. ^ 

The curves of the spine in childhood are 
somewhat different in the sitting and stand- 
ing positions. In sitting, the lumbar curve 
is often obhterated, making the spine practically straight, until 
a child is about thirteen years of age.^ 

In a standing position the curves are more apparent. In 
judging the contours of the spine for educational purposes, the 
appearance of the back, especially in children of school age with 
the clothing on, is of even more importance than the actual 





1! 


m 


■ 


t 








h 


^ 








'y 




3 








I 


-i 














\ 














1 


, 








t 


/ 


1 








w 


•J 










m 


f 






I 


M 


m 








/ 




i 


1 








i 


f 


k_^ 





Fig. 1 6. — Effect of 
exaggerated dorsal 
curve on position 
of chest iJegi) . 



^ The order and age for the appearance of these different curves varies somewhat 
in the statements of different authorities, but they agree that the curves are present 
habitually in the standing position by three years of age. See Cunningham, 
Aeby, Dwight, Rasenal, Lovett, Davis and Montgomery. For summaries, see 
Rotch, ii8; Cotton, 24; Lovett, Davis and Montgomery, 89; Lovett, 86. 

2 Lovett, Davis and Montgomery, 89 ; Lovett, 86, p. 14. 



THE SPINE 



35 



anatomical facts as they appear to the expert on closer examina- 
tion. The back of a baby, sitting on one's knee, is straight and 
square (see Plate IX). Stand the little one on its feet, and 
the back curves out over the buttocks.^ 
When a child enters the kindergarten 
at four years of age, the back appears 
to be perfectly straight above the but- 
tocks. This straight back (Fig. 17) is 
characteristic of a child standing in 
good posture until about the third grade 
(nine or ten years of age) , when the lum- 
bar curve begins to be a noticeable fea- 
ture of the contours in a standing posi- 
tion. The degree or depth of this 
lumbar curve, or hollow in the back, 
varies with different children, and 
always, after the curve becomes ap- 
parent, it blends into the lower part of 
the dorsal spine, so that both curve out- 
ward and upward just above the great- 
est hollow in the back. Assuming that 
all of that part of the spine which is 
concerned in the hollow of the back 

may be called the lumbar region (and for Fig. 17. — Contours of six- 
year-old boy {Symington) . 
practical school use this is the easiest 

identification), the back from there up should appear practically 

flat. In judging the contours of the figure in the region of 

^ The bony foundation for this curve of the buttocks is, at all ages, the sacrum, 
with a slight outward curve of the lowest lumbar vertebrae blending with it. The 
lumbar curve at all ages may be definitely located by the top of the hip bone 
(ilium), which is always on a level with next to the lowest vertebrae (the fourth 
lumbar). 




36 THE POSTURE OF SCHOOL CHILDREN 

the shoulders, one must remember that the shoulder blades 
(scapulae) are nearer the surface than the spine, and have 
much to do in determining the contours. If the shoulder 
blades are not fiat on the back, they may give the back an 
appearance of bowing out at the shoulders, when the dorsal 
curve itself may not be exaggerated. When the spine is 
involved, the running forward of the neck is always a sure in- 
dication. If the shoulder blades are correctly placed, the back 
should appear flat in the dorsal region. 

When children reach the upper grades of the elementary 
school (twelve to fifteen years of age), the curves of the spine 
all become more pronounced. The clothing of boys so conceals 
the figure, that until one has somewhat acquired an X-ray ability 
to discern what is beneath, it is far easier to judge by inference 
with the line test for the whole trunk if the curves of the spine 
be normal. In girls, the dress usually aids the discernment of 
the contours of the spine, at least in the lumbar region, and the 
• increase in growth in the length and depth of the lumbar curve 
may be plainly seen. This curve is piore pronounced in grammar 
grade girls than in boys of the same age, foreshadowing the adult 
lumbar curve, which is longer and deeper in women than in men. 

Such, then, are the contours of the erect spine throughout the 
years spent in the elementary school. If every child grew nor- 
mally into these contours, there would be much less need for physi- 
cal training than at present. Unfortunately, however, the ex- 
aggerations of the curves already described occur in a majority 
of children at some time through the growing period, if definite 
training be absent. The weak place in the lumbar curve, es- 
pecially, begins to show in the first primary grade, or even in the 
kindergarten with children six years of age, in a sinking back- 
ward of the upper part of the trunk. With these very little 



THE SPINE 37 

children this is not necessarily an habitual attitude, — which 
it may become later, — but constantly recurs in a fluctuation 
from the erect position, a fluctuation that is one expression of the 
undeveloped motor power of these very young children. They 
lack steadiness, precision, and strength in all of their movements 
— an immature state that is perfectly natural and characteristic 
at that age. This weak motor power shows in no way more 
clearly than in the instabihty with which these httle children 
hold the erect position. How early one may begin to train the 
sense of erect posture, and the muscular power to maintain it 
is among the most serious and diflicult of the many teaching 
problems connected with this subject. The writer's judgment 
is that the second year of the primary school (when pupils are 
in their eighth year of age) is soon enough for definite, formal 
training in posture, though some of the muscular control necessary 
for it may be begun with a very little formal gymnastic work 
before that time. Before the seventh or eighth year of the child's 
age, however, the informal activities of many of the kindergar- 
ten games, and the story gymnastics and recreative exercises 
of the lower primary grades, may be good means of approach- 
ing the subject, if carefully selected with that end in view. 
Even from the lowest grade one needs to be watchful for the 
inherent weakness in the lumbar spine. Throughout the school 
years the entire spine, but the lumbar region especially, needs 
attention and training for muscular strength and right habits 
of carriage. 



CHAPTER V 

THE SPINE, U: ANTERO-POSTERIOR CURVES; THEIR EFFECTS 
ON TRUNK CAPACITY AND HEALTH 

The importance of proper erectness in the spine, and the harm 
that comes from exaggerated curves, Hes primarily in the fact 
that the latter affect the diameters of the trunk, altering its pro- 
portions. Trunk capacity, or relative size of the trunk, is one 
of the most important elements in a good physique, for it im- 
plies relatively large organs and plenty of room in which they 
may do their work, — in short, the right conditions for a large 
working machinery for the body. It is usually found that men 
of large endurance and achievement, who have not had to 
struggle against the handicap of ill health, have relatively large 
trunk capacity (Plate V) . This is very apparent in Washington 
and Lincoln, in whom the trunk forms a relatively large propor- 
tion of the height. 

Dr. Tyler discusses ^ the general tendency to weakness when 
a proportionately large part of the total height is made up of 
length of legs; and the greater strength and vigor of the organism 
when the size of the trunk is proportionately large. He bases 
much of his argument for education at different ages on the 
relative proportion of the trunk to total body height, because 
of the related physical and mental vigor, liability to disease, 
etc. 

Trunk capacity may be small in a tall person, or large in one 

1 Tyler, 140; pp. 153-154, 160-161. 

38 




Peale 



Plate V. — Washington. 
{Courtesy Metropolitan Museum of Art.) 



THE SPINE 



41 



who is short, the total height being determined by the length 
of legs. The sitting height is usually considered a general indi- 
cation of the height of the trunk, or its 
capacity in its long or vertical diameter.^ 
The depth (from front to rear) and breadth 
(from side to side) give other means of 
estimating the size of the trunk and are 
called respectively the antero-posterior 
and lateral diameters. Finally, the girths, 
giving the total circumference of the 
trunk, are an indication of size and 
very important, though as regards cor- 
rect posture and proportionate develop- 
ment of the chest, they are far less 
enlightening than the diameters, for 
girths do not show the relative contours 
and position of the different parts. 

When the antero-posterior curves of 
the spine are exaggerated or increased, 
as in poor posture, they lessen the ver- 
tical diameter of the trunk. In Fig. 18 
the dark line, measuring in length ex- 
actly the same as the spinal column on 
which it is placed, is drawn in exaggerated 
curves analogous to those of the spine 
in poor posture. The difference in height 
is at once apparent. The author has 
measured pupils in the classroom who 

showed a difference between good and poor posture of from one to 
three inches in the total height of the body. Dr. Goldthwait has 

1 For table of sitting heights for different ages, see Chapter VIII. 




Fig. 18. — Showing how 
height is decreased by- 
exaggerated curves in the 
spine. 



42 



THE POSTURE OF SCHOOL CHILDREN 



reported a variance from the 
true height of from one half to 
three quarters of an inch as a 
result of the second type of poor 
posture — that in which the 
lumbar curve is obliterated and 
the back flat. The antero- 
posterior diameter of the trunk, 
or its depth from front to rear, 
is also affected by these faults 
of posture, especially in the 
upper part of the chest, where 
is situated the apex of the 
lungs, in which tuberculosis is 
likely first to develop.^ 

It is needless to say that the 
proportions of the trunk cannot 
be thus altered without crowd- 
ing or displacing the organs in 
a manner that interferes with 
the circulation through them 
and the performance of their 
own functions. 2 Unless one 
reflects on the fact, he does not 

Fig. 19. -Relation of the^ns of the appreciate how large a part 
chest and abdomen to the clothing, movement plays in the func- 

{From Ptlcher s First Aid, by courtesy ^ -^ 

of Messrs. Charles Scribner's Sons.) tiouiug of the thoracic and 

abdominal organs. For example, respiratory action, the work 
of the heart, and the digestion of food are all impossible without 

1 Goldthwait, 48. 

2 Goldthwait, 48 and 49 ; Kellogg, 77, 79, 80, 81 ; Herz, 64 ; Forbes, 41 ; Martin, 
96, 97. 




THE SPINE 43 

muscular contraction and relaxation in the organs concerned. 
Of especially grave importance, however, is the actual displace- 
ment of organs through poor posture. The X-ray work of Drs. 
Goldthwait, and Brown, and Martin has shown that through 
displacement from poor posture the stomach may be put in 
such a position that the food cannot pass out of it. There 
is scarcely an organ of the trunk of the body that has not 
been found very seriously displaced through poor posture. 
The functional disturbance arising from such displacement 
has far-reaching effects, and through the lowered tone and 
vigor of the system that results, the power of resistance to dis- 
ease is greatly lessened. On these points Dr. Goldthwait says : — 

" The sides and anterior wall of the abdomai consist practically 
wholly of muscle, the arrangement of the fibers being such that the 
greatest elasticity exists without sacrificing the element of strength. 
The proper tone of this anterior muscle wall is an important part of 
the support of the abdominal viscera. Besides this, the viscera are 
supported by ligaments, by the formation of the bony framework, 
and by the arrangement of certain of the structures so that definite 
ridges or shelves exist, upon which the organs naturally rest. When 
the body is erect, all of these elements work to the best advantage. 
All of the abdominal muscles are made tense so that the organs are 
held firmly together with little liability to drag out of place. The 
ligaments are subjected to the least strain, and the organs rest most 
securely on the ridges or shelves. ... In this position the kidneys 
cannot become displaced, the stomach cannot drag downward, nor 
can the other viscera change their normal relations to each other. 
Under such conditions there is also the least possible interference 
with the circulation, which, together with the freedom from strain of 
any of the structures, would naturally insure the greatest efficiency 
in their function." 

And again, 

"Since the normal function of the organ must depend to a con- 
siderable extent upon the position Xbecause of the arrangement of the 



44 THE POSTURE OF SCHOOL CHILDREN 

blood vessels and nerves, as well as because of its relations to the 
other organs), the importance of training the body to habits in which 
there will be the minimum of displacement of the viscera cannot be 
overemphasized . ' ' 

If these matters are important to an adult, they are even 
more so to a child, for besides supplying the waste and repair of 
daily activities, the great functions have in childhood to provide 
for the enormous growth in bulk that must take place. When a 
boy enters the elementary school at six years of age, he has but 
one third of a man's weight. During the elementary school 
course he gains fifty or sixty pounds, and in the high school 
adds thirty or forty more. Besides adding to the other tissues 
of the body, the organs that are supplying all this material have 
at the same time to undergo a great increase in size, for this is 
their growing time also. During the elementary school period, 
for example, the heart more than doubles in weight, the lungs 
gain practically three times their weight, and the liver more 
than doubles.^ 

Indeed, the most rapid weight increase of heart, lungs, liver, 
kidneys, and spleen occurs from twelve to fifteen years of age, 
just at a time when a slouching carriage most often attracts 
attention. Such a weight, pulling directly or indirectly upon 
the spine, cannot but have its influence on posture, especially 
if, as Donaldson suggests,^ the most rapid growth of the mus- 
cular system comes later, so that the muscles are comparatively 
weak for the great increase in weight which they must support 
in these later grammar school years. 

It is apparent from all of these facts that there is no time 
in life when poor posture could do more lasting harm to physical 
condition and development, or good posture be of greater advan- 
tage, than during the school years. 

1 Vierordt, 162. 2 Donaldson, 32. 




Plate VI. — Sitting Philosopher. Louvre. 
The Bowed Back of Age. 



CHAPTER VI 
THE SPINE, ///; LATERAL CURVES 

The ways of detecting lateral deviations from the erect posi- 
tion of the spine have been described in Chapter 11. Whenever 
indications of one-sidedness are found, the judgment of an expert 
should be sought at once to determine whether or not the spine 
itself be affected. Sometimes from some habit of posture or 
occupation, one shoulder may be lower than the other without 
involving the spine. This can usually be corrected by special 
exercise. Sometimes a defect in the eyesight may cause a one- 
sided carriage of the head, and the oculist may remedy that. 
Whatever the cause for one-sided carriage, it is of much impor- 
tance that it be found and removed, for eventually the spine 
may become affected. 

In most cases that show one-sided asymmetry there will 
probably be found a lateral curve of the spine. The accompany- 
ing cuts show the difference in outline made in the skeleton 
(Figs. 20-21) and in the full figure (Figs. 22-23), by a single 
lateral curve of the spine. In the full figure note the different 
heights of the two shoulders from a horizontal line, and similarly 
the height of the axilla (armpit) and the hips. The diver- 
gence of the spine and head from the vertical line are equally 
apparent. There may be two lateral curves in the same spine, 
instead of only one, as shown in these illustrations (see Fig. 60) ; 
often there is easily discerned a rotation or twisting of the spine to 
one side. In the case of such rotation one shoulder blade may 

47 



48 



THE POSTURE OF SCHOOL CHILDREN 



become more prominent than the other. As before stated, it is 
not for a layman to decide whether or not a lateral curve of the 
spine exists, of what kind it is, or how serious. Any case showing 
these one-sided deviations should be referred at once to compe- 
tent authority for diagnosis, preferably to a physician who has 
specialized in orthopedics. 




Figs. 20-21. — Diflferences in the position of the skeleton in the normal attitude and in 
lateral curvature of the spine. {From Mosher's "Health and Happiness," by courtesy 
of Dr. Mosher and Messrs. Funk and W agnails.) 

Lateral curvature of the spine, or scoliosis, is classified in two 
main divisions or groups, according to its severity, one called 
functional or postural scoliosis, and the other structural scohosis. 
In postural, or functional, scoliosis, the actual structure of the 
spine itself has not been altered, and the position probably 



THE SPINE 49 

comes from a weakness or habitual one-sided use of the muscles. 
Vigorous special treatment, of which gymnastics may form a 
considerable part, is necessary for such a condition and may 
entirely remove it. The child's own sense of the erect position, 
and his power to assume it, should be especially trained and ap- 
pealed to. Good school gymnastics should benefit such a child, 
though in most cases not enough and not sufficiently specialized 
for him. He should have ample outdoor exercise, and nourish- 
ing food; he should avoid the carrying of heavy weights, and 
overwork in any form; in short, he should have good hygiene 
in all particulars to keep the constitution vigorous. 

In structural scoliosis, which is much more serious, the 
shape of the bones and cartilage discs has become affected, and 
it is of great importance that these changes be checked, and if 
possible corrected. Scoliosis is more amenable to help during 
years of growth than later, and the treatment by a specialist 
should have faithful, persistent cooperation from the patient, 
as the condition cannot be quickly overcome. 

Scoliosis and its treatment are not necessarily painful unless 
there be complications. The curvature leads, in most cases, 
however, to weakening of the constitution, that renders the indi- 
vidual less robust, more susceptible to fatigue, and places him 
otherwise at a disadvantage. In the crowding and displacement 
of the internal organs, the effects are analogous to those resulting 
from antero-posterior faults of posture. Indeed, the antero- 
posterior types of poor posture often accompany scoliosis, and 
Dr. Goldthwait suggests that they may precede and lead into 
scoHosis. Children with lateral curvature of the spine need not 
be excluded from regular school gymnastics, unless they be 
wearing a brace, cast, or jacket, unless they complain of pain, 
or, because of some comphcation, the physician has ordered 



50 



THE POSTURE OF SCHOOL CHILDREN 



suspension of exercise. Where there is a tuberculous condition 
of the bones, exercise of any kind is considered harmful, but with 
the exception of the conditions mentioned, positive advantage 
may accrue to a scoliosis case from the general upbuilding of the 
system through gymnastics and other exercises. If not carried 
to the point of fatigue, the change of position which these ac- 
tivities afford, and their definite training of the muscular sense 
of erect posture, are also a positive advantage. 

It should not, however, be thought for a moment that the 




Figs. 22-23. — The normal position and lateral curvature {Mosher). 



usual school exercise, designed for normal children, is sufficient 
for the correction of scoliosis cases even of the mildest func- 
tional type. It is to be hoped that in time there will be a large 
enough corps of physical training specialists in our schools to 
give corrective exercise to such cases under medical advice and 
cooperation. A considerable number of pupils having lateral 
curvature could be gathered together in any large school or group 
of schools. Such work in school will probably always be the 
only way to secure regular and adequate help of this kind for 



THE SPINE 51 

many children, whose after-school conditions are not favorable 
to proper treatment, even at free clinics. 

Exercise, however, is by no means the only or the best means 
of treatment for many cases of scoliosis, and, indeed, in struc- 
tural cases it may be of no use. So it becomes important to 
repeat that all cases of lateral deviation should have medical 
advice. 

The subject of lateral curvature will not be dwelt on in suc- 
ceeding chapters, as the main concern of the present work is 
with antero-posterior deviations. 



CHAPTER VII 
THE HEAD 

The position of the head is of much importance in the general 
posture of the body, because of its direct influence on the spine, 
chest, and shoulders ; it also affects the position of the stomach, 
liver, and other abdominal organs which are suspended seconda- 
rily from the neck. In a perfectly balanced position, where the 
least muscular effort is required to maintain it, a considerable 
part of the head and neck is carried back of the hne of gravity. 
This line of gravity is well in front of the ear, — just how far may 
vary in different individuals. 

The erectness of the head may best be judged by the contours 
of the neck, for the two are so closely associated they cannot 
be considered separately. 

The proportionate length of the neck is very different in infants 
and older children, being relatively very much shorter in a baby 
(see Plate IX). This is because the first rib lies horizontally 
in the infant, its front attachment to the sternum, or breast bone, 
being directly opposite the first dorsal vertebra, to which it is 
attached at the base of the neck behind. Later the sternum 
sinks in front so that the first rib slants downward and forward, 
making a longer throat line, In adult men the top of the sternum 
is opposite the second dorsal vertebra, and in women it is still 
lower, being in them opposite the third dorsal vertebra. This 
gives to women the appearance of having a longer neck and 
throat than men have.^ 

1 Gray, 152; Dwight, 149; Piersol, 157; Fitterolf and Gittings, 38. 

52 



THE HEAD 55 

The vertebrae in the neck are of no help in determining the 
contours, for they He so deep under other tissues that except at 
the very base in the back, where they blend into the outward 
and downward slope of the dorsal curve, they are not apparent 
in the outhnes. The- natural curve in the cervical vertebra 
is with the concavity facing to the rear, or in the same direction 
as the lumbar curve. The common fault in bad carriage of the 
neck and head is that they droop forward, yielding to the pull 
of gravitation. This makes the column of the neck slope forward 
instead of being upright (Fig. 24). ^ The effect of this forward 
droop of the neck on the cervical curve must be to obliterate it, 
just as the lumbar curve is obliterated in the straight-back posi- 
tion described in Chapter II as the second type of poor posture. 

When the neck slopes forward in this way, the effect on the 
spine, chest, and shoulders is to drag them downward and for- 
ward also. In such a position of the neck, the back is affected 
through the dorsal curve. This shows in the upward and forward 
slope of that curve, which, instead of blending in outline with 
only the lowest two cervical vertebrae, is continued in a long 
line forward throughout the length of the neck. The back is 
thus bowed out under the shoulder blades, in an exaggeration 
of the natural dorsal curve. 

With this increased dorsal curve the chest sinks downward 
and backward, an effect that is intensified by the relaxation of 
an important muscle (the sterno-cleido-mastoid) on the sides 
and front of the neck, which, with its colleagues, influences the 
relative position of the chest and head. This muscle is attached 
to the head at the lower part of the skull just back of the ears, 
and comes forward and downward, spreading out to be attached 
in front to the collar bones (clavicles) and the sternum (breast 

1 Appendix, Note 6. 



56 



THE POSTURE OF SCHOOL CHILDREN 



bone). When the head is fixed in the upright position, these 
sterno-cleido-mastoid muscles, pulling equally on both sides, 
tend to lift the chest and hold it up in place. If the chest be 
held firmly in a good position, these muscles might act in just 
the opposite direction and pull the neck forward. If the neck 
be drawn forward in this manner, however, it almost in- 
variably results in such a relaxation of these sterno-cleido 

muscles that the chest 
droops downward also in 
a collapsed or sunken posi- 
tion. 

The shoulders are nearly 
always too far forward 
when the head and neck 
are thrust forward. Hold- 
ing, as the shoulders do, 
the weight of the arms, a 
forward sag of the chest 
or back gives them the ex- 
cuse for slipping forward 
in a yielding to gravita- 
tion for which they seem 
always in readiness. 

In all this action and 
interaction of head, chest, and shoulders, one sees the working 
of the mechanical instinct for balance in the body. It matters 
not which is the first offender, — head, dorsal curve, or 
shoulders ; as soon as one gets away from its balanced position 
in relation to the line of gravity, the others counterbalance 
it with a poor position also. 

Several very potent causes besides this mechanical reaction 




Fig. 24. 



Forward slope of the neck in bad 
carriage of the head. 



THE HEAD 



57 



tend to pull the head forward. Defective sight and hearing 
are among those most frequently met. It is exceptional not to 
find need of correcting the head position of a child wearing 
glasses for nearsightedness or astigmatism, and weakness of both 
sight and hearing may often be first 
detected through this unconscious reach- 
ing forward of the head in an effort to 
help an imperfect sense. A sidewise 
tilting of the head, especially accom- 
panied by squinting of the eyes, often 
accompanies astigmatism or other errors 
of refraction in the eyes, and should 
have the attention of an oculist. 

Another possible cause of poor head 
positions has recently been suggested 
by Drs. Goldthwait and Brown. ^ They 
point out that much of the weight of 
the liver, stomach, and colon, attached 
as they are to the diaphragm, pulls on 
the neck through the fascia (tissues) that 
support the diaphragm from the cervical 
vertebrae. As the weight of the liver 
alone at fifteen years of age is 1420 
grammes,^ the significance of such a pull 
on the neck muscles becomes apparent, 
as well as the importance of maintain- 
ing a position of bones and ligaments 
so balanced that the strain shall not be thrown wholly upon 
the neck muscles. 

Drs. Goldthwait and Brown, after describing the sagging out 
1 Goldthwait and Brown, 49. See also Baker, 3. ^ Vierordt, 162. 




Fig. 25. — A fashion plate. 



58 ' THE POSTURE OF SCHOOL CHILDREN 

of place of the viscera through the yielding of the cervical ver- 
tebrae in a poor position of the neck and head, say : — 

''The writers feel that the full significance of the cervical fascia 
as the supporting ligament of the diaphragm, and consequently as 
part of the support of the abdominal viscera, has not been generally 
appreciated, and is consequently given special emphasis at this time. 
In the X-ray study of this subject it has been clearly shown that by 
merely changing the position from the droop to the erect position 
[of the neck], the position of the bottom of the stomach can be raised 
from one to two inches." 

There is another position of the head, other than that induced 
by the neck, that is involved in correct carriage; namely, its 
tilt on the neck, which hfts or lowers the chin. In a quiescent 
standing position the general direction of the chin should be 
horizontal. The skull is so poised on the top of the spine that 
it very easily tips backward with the chin elevated in the air ; 
on the contrary, a habit of casting down the eyes may lead to the 
opposite fault of depressing the chin. As temporary attitudes, 
there is no harm in either of these positions, but the habit of 
the erect position when4hat is assumed should be with the neck 
upright and the chin level. 

In correcting the position of the neck and head, a clear dis- 
tinction has to be made between drawing the neck backward so 
that it is an upright column, and merely tilting the head back- 
ward on the neck as just described. 

The effect of the carriage of the neck and head on the total 
height of the body is very marked, and the impression created 
by their position is fully equal to that made by the posture of 
chest and spine. A well-poised head is one of the most beautiful 
points of a fine physique, and no factor is more important in 
the general impression of intelligence and efficiency unconsciously 
conveyed by the carriage of the body. 




Sir Frederick Leighiun 



Plate VIII. — " Hit. 



" TJ^rr. " 



CHAPTER VIII 
THE CHEST 

No part of the body undergoes in the process of growth 
greater changes in its proportions, shape, and contours than the 
chest, and for no part are the right Hnes of growth so often mis- 
understood. 

The chest, or thorax, is that part of the irunk which is in- 
closed by the ribs and contains the heart and lungs (Fig. 26). 
It is separated from the abdomen by the great, flat breathing 
muscle, the diaphragm, which forms a distinct floor for it, 
though one that moves upward and downward with every breath. 
The ribs are attached behind to the dorsal spine, which holds 
them in a perfectly normal position when itself erect, with only 
its natural curve, but allows the ribs to sink downward in a 
collapsed position when the dorsal curve is increased or exag- 
gerated. On the other hand, a backward tilt of the dorsal curve, 
as in the ''bantam" attitude, fixes the ribs in an unnaturally 
distended position. 

In front, the upper seven ribs are attached to the breast bone, 
or sternum, the next three each to the rib above it, and the 
last two are short so that they are mainly in the back and their 
outer ends are not attached to anything, from which fact they 
get the name of floating ribs. The collar bones (clavicles) lie 
across the top of the chest in front, being joined also to the ster- 
num above the ribs. The clavicles are a part of the shoulder 

61 



62 



THE POSTURE OF SCHOOL CHILDREN 



girdle, and are not considered part of the chest, though their 
weight and position, and their attachment to the sternum, may 
help to depress or maintain the correct position of the chest. 

The features in the chest, aside from its actual gain in girth, 
that undergo the greatest change during the years of growth, 
and that are most influenced by posture and other factors con- 
tributing to physical development, are (i) the proportion of 
depth to breadth ; (2) the obliquity or slant of the ribs ; (3) the 

obliquity of the sternum ; and 
(4) the mobility, or extent to 
which the ribs move, in breath- 
ing. 

The chest of an infant is very 
deep (from front to rear) in 
proportion to its breadth (from 
side to side). This gives the 
body a very round, compact form, 
as may be seen in Plates IV 
and IX. As a child grows older, 
this proportion changes, so that 
the breadth, measured with cali- 
pers from side to side under the 
arms, is much greater than the depth from sternum to spine. 
The effect of this is to make a broad, flat chest, comparatively 
thin through the body, and such a chest is rightly characteristic 
of children in the upper primary grades and from then on through 
adult life (see Plate VIII). ^ 

Dr. Tyler remarks that "the flatness or hollo wness of the chest 

^ Gray, 152; Dwight, in Piersol, 157, and other standard anatomies; Fitter- 
holf and Gittings, 38; Hall, 55; Holt, 66; Hutchinson, 68, 69, 70, 71 ; Jaeger, 74; 
Oppenheim, 108; Rotch, 118; Sargent, 122; Trettien, 138; Tyler, 140; Whit- 
man, 143 ; etc., etc. 




Fig. 26. — The thorax (chest), showing 
relation of ribs to heart and lungs. 
c, clavicle ; s, sternum ; /, lungs ; 
I, 2, 3, etc., ribs. 



THE CHEST 



63 



of the boy or girl at ten or eleven, and its depth in the baby, 
are apparent to every one." ^ And Dr. G. Stanley Hall says, 
''As' the thorax has flattened from front to back and broadened 
laterally as man became erect, a change also marked from infancy 
to maturity, the adolescent chest 
growth is mainly lateral.' ' ^ 

There is a very persistent, 
popular idea that a good, full 
chest in a child or adult must 
be one that pufTs largely out- 
ward and upward in front. No 
mistake could be greater ; it is 
only the infant that has such a 
contour of chest, and in the de- 
velopment of a child, while the 
chest should gain in depth, every 
effort should be made to assist 
nature in establishing a chest 
that in its contours is broad 
and comparatively flat. Con- 
versely, everything that tends to 
perpetuate the greater propor- 
tionate depth is a detriment 
and a mistake. Some of the 
worst deformities of the chest, 
such as pigeon breast, are ex- 
aggerations of the antero-pos- 
terior depth, while arrested de- 
velopment, preventing the broadening out or flattening of the 
chest, is found to exist in a majority of cases of tuberculosis, 

^ Tyler, 140, p. 67. ^ Adolescence, 55, p. 69. 




Courtesy of Dr. Gcldthwait 

Typical tuberculosis chest, 
taken at random from a tuberculosis 
class. 



Fig. 27. 



64 THE POSTURE OF SCHOOL CHILDREN 

the interference with free respiration evidently being a predis- 
posing cause. 

Dr. Woods-Hutchinson, whose investigations on chest pro- 
portions have been of great significance, found that the typical 
consumptive chest, far from being fiat in the sense of being thin 
from front to rear, is proportioned like the infant chest — thick 
in depth in relation to its breadth. This has been corroborated 
by numerous other investigators. The appearance of flatness 
in such cases comes from the collapsed posture, with the sliding 
forward of the shoulders, which always tends to make the chest 
look fiat and narrow. Of the proportions ''implied in the terms 
flat-chest, hollow chest, etc.," Dr. Hutchinson says : — 

"The more carefully one inspects chests of this class, the more 
one is struck with the extent to which this flattening is apparent and 
not real. In the first place, even in popular terminology, 'flat- 
chestedness' is almost invariably associated with 'round shoulders.' 
In other words, the flattening of the anterior aspect [front] of the 
chest is in a very large measure due to the forward movement and 
carrying of the great muscular masses of the shoulder girdle. Our 
standard of flatness or fullness of chest is simply a line drawn across 
it from one acromion process [shoulder tip] to the other, and it is 
obvious that we may have a distinct flattening of this line with a 
decided round chest, provided that the shoulders be forward far 
enough. As is already suggested in the term round-shouldered, even 
a mere glance at the hollow chest will show us that a very large pro- 
portion of this anterior flattening is due to the gliding forward of the 
scapulae [shoulder blades] and their attachments so that the posterior 
outline of the upper part of the chest wall [upper back under the 
shoulders], instead of being almost a straight Hne, as it should in the 
ideal position, is a very decided curve. And upon the application of 
accurate methods of measurements we find ourselves confronted with 
the surprising situation that our so-called flat chest is really, if any- 
thing, slightly above the normal in its antero-posterior diameter." ^ 

1 Hutchinson, 68. 



THE CHEST 65 

As Dr. Hutchinson says, the typical tuberculosis chest, as 
regards these proportions, is 'Hhe persistent immature chest" — 
one that is too deep proportionately from front to rear.^ 

The relation of the antero-posterior measurement of the 
chest, or its depth, to the lateral measurement, or breadth, is 
called the chest index, and this is one of the most important 
points to be established in taking the physical measurements 
of an individual. Using the lateral measurement as the standard, 
and calling it 100, the antero-posterior measurement at birth 
is the same or a little greater; at seven years of age it is only 
about seventy per cent of the lateral diameter, and reaches its 
lowest index at from twelve to fourteen years of age, when it is 
only from sixty-two to sixty-five per cent. After this, the growth 
in depth seems to overtake somewhat the widfh, for the normal 
index in the adult is from seventy to seventy-two per cent.^ 

To quote from Dr. Woods-Hutchinson : — 

"At birth the diameters [of the chest] . . . are almost equal, 
while from this period up to the twelfth or thirteenth year, and to 
the twenty-fifth, even, there is a gradual, steady modification of the 
chest shape, until the full adult 'bellows' form is reached, in which 
the diameters are exactly reversed, viz., as two to three in favor of 
the transverse." And again, "In fact, almost incredible as it may 
seem, we have been misled by analogies drawn from the animal king- 
dom, and instead of the- ' deep ' human chest, that is, the chest with the 
long antero-posterior diameter being the type of vigor, it is just the 
reverse, and the healthy, vigorous human chest is the broad, flat, well- 
expanded, low-indexed type." ^ 

The contours of a child's chest change, then, from the promi- 
nent, rounded-out appearance of the very little child with short 

1 Woods-Hutchinson, 68, 69, 70; Evans, 36; Whitman, 143. 

2 Hutchinson, Ibid.; Dwight in Piersol, 157; Tyler, 140. 
' Hutchinson, 69. See Appendix, Note 7. 



66 THE POSTURE OF SCHOOL CHILDREN 



4 



neck (sometimes called the barrel-shaped chest) to the compara- 
tively thin, flat-chested outlines of the boy and girl in the upper 

primary and the grammar grades 
(Figs. 28-29). The characteris- 
tics of chest and neck of a very 
young child help to place the 
age of the quaint little figure 
of the artist Strozzi's daughter 
in Titian's portrait in Plate 
XVIIL 

Fig. 28.— Outline of the chest of a child Xhe age of greatest flat- 
three years old, level of seventh dorsal 

vertebra. Note the great depth in pro- chestcdnCSS (eleven tO fifteen) 
portion to breadth. (After Dwight.) 

is followed in the later high 
school years by one in which the chest appears sHghtly 
higher, — an appearance that probably comes from a greater 
protrusion of the sternum. This outward slope of the sternum 





Fig, 29. — Outline of the chest of adult at level of sixth dorsal vertebra, showing how 
the chest has broadened and flattened from the round, deep proportions of the three- 
year-old child. {Adapted from Braune and Bellamy.) 

should be kept through adult life (see Fig. 39) ; but here 
again it is necessary to add a word of caution against mis- 
taking the moderate contours of the perfectly erect position 



THE CHEST 



(^1 



for an exaggerated lifting and puffing outward of the chest,— 
a position that may always be detected by the forced distention 
of the ribs, and the acccompanying lordosis (excessive hollow 
in the back). 

Dr. Tyler remarks of the changed proportions at different 
ages : — 

"The boy at twelve or thirteen, and the girl a year or two earlier, 
are farthest from the proportions of the infant. Adolescent and adult 
tend to return to the proportions of childhood. This is very clear in 
the relative length of trunk and legs, in girth of chest, and even more 
in its form and roundness." 

The following conclusions of Dr. Hutchinson's indicate 
plainly the duty of physical education in the development of the 
chest in children : — 

" I. The typical tuberculosis chest is round instead of flat and has 
an average index of about 80, nearly 10 degrees above the normal 
\i.e. the depth is 80 per cent of the width]. 

" 2. This type of chest precedes the disease. 

"3. It is an abnormal persistence of the fetal, infantile, and child 
type of chest. 

"4. Any chest more than 18 years of age, which shows an index 
of 80 or higher should be regarded as abnormal and as rendering its 
possessor more than usually liable to tuberculosis. 

"5. The occurrence of such a chest in any patient over 18 years 
of age, suspected of tuberculosis, raises a strong probabihty of the 
disease. 

"6. The chests of growing boys and girls should be systematically 
measured at stated intervals, and whenever the index is found dis- 
tinctly higher than normal for their age, active measures should be 
taken to remedy the defect. 

"7. All those sports and exercises which involve wide swinging 
use and play of the arm, chest, and shoulder muscles, such as tree 
cHmbing, swinging from ladders, from rings, from bars, ball throwing [?], 
spear hurling, tennis, swimming, will tend to correct this defect and 
flatten the chest down to its normal width." 



68 THE POSTURE OF SCHOOL CHILDREN 

The change in the proportions and shape of the chest as it 
develops is accompanied by changes in the position of the ribs 
and sternum that need to be understood for correct ideas of 
development. In the infant most of the ribs, especially the upper 
seven, are nearly horizontal, coming practically straight around 
to the front from their attachment to the spine. As the child 
grows older, the sternum and the ribs sink, so that the ribs slope 
downward from the spine. The short, upper ribs, that make 
the opening, or base of the neck, sink down in front with the 
sternum, to which they are attached, the length of one or two 
vertebrae (as explained in discussing the head). This makes 
a longer throat line. The ribs below this (except the two 
little, straight floating ribs at the bottom) come to slope down 
very much more, so that they form a deep loop on the sides and 
are caught up again in front. This slant or loop is called the 
obliquity of the ribs and is very important, as it increases the 
capacity of the chest in breathing, and economizes the effort 
needed for its expansion, giving a much greater range of move- 
ment for the same amount of muscular work. 

'^The obliquity of the ribs adds greatly to their range of move- 
ment in respiration . . . and serves also the purpose of securing the 
necessary expansion of the chest with the least possible motion in the 
joints between the ribs and the spine, and between the cartilages of 
the ribs [i.e. their front or anterior ends] and the sternum. They are 
thus but little liable to strain, and, in spite of their unceasing move- 
ment during life, are very rarely the seat of either dislocation or 
disease." ^ 

The infant with nearly horizontal ribs has to breathe from 
thirty-five to forty-four times per minute to supply his needs, 
while at fifteen years of age, the ribs being oblique, eighteen 

1 Piersol, 157. 




Plate IX. — Boy with a Goose. Munich. 



THE CHEST ^i 

to twenty respirations per minute suffice. While numerous 
factors are involved in this change in respiration, the obhquity 
of the ribs is significant. 

Finally, the breast bone, or sternum, undergoes marked 
changes in position during the years of growth. In the infant 
it protrudes at an angle much nearer to a horizontal plane than 
later. In the child of the intermediate and upper elementary 
school it subsides to much nearer a vertical position, making 
the chest appear flat. In the adult, it would seem that the ster- 
num comes to slope outward a little more, though never again 
so much as in the infant, for the adult chest index rises to its 
normal seventy per cent from the sixty-two of the child's period 
of very flat chest; but even at its deepest, Uie contours of the 
adult chest are never those of the "chesty" attitude. Always, 
the broad chest is more valuable than the proportionately deep 
one. 

The application of these points of development to posture is 
of primary importance, for the proper development can be 
most obviously helped or hindered by habitual positions. In 
relaxed attitudes, where the back bows out and sinks backward 
and the chest is depressed, the functional activity of the ribs 
in breathing is plainly interfered with. Dr. Kellogg says on 
this point : — 

"In having a round-shouldered, flat-chested person breathe into a 
spirometer after a full breath, I have found the lung capacity to be 
only 2 70 [cubic inches] ; whereas the same person standing in a proper 
position was able to expel 310 inches after taking a full inspiration, 
an increase of fifteen per cent. 

''The involuntary inspiration must be interfered with [in poor 
posture] to an even greater extent. The person breathing in a stooped 
position is constantly in a state of air starvation, — a fact which is 
evidenced by the disposition to straighten up and draw a long, deep 



72 



THE POSTURE OF SCHOOL CHILDREN 



breath every now and then, which is constantly noticed in persons 
who sit at study or work in a stooped attitude." ^ 

Obviously, for full, normal lung action, a proper position of 
the chest is of primary importance. A collapsed, shrinking 

attitude of the chest is 
characteristic of weak 
or diseased lungs. The 
subject shown in Fig. 
27 was selected at ran- 
dom from a tubercu- 
losis class. The posture 
is the same as that of 
the fatigue position. 

It remains to con- 
sider the effect on chest 
development of the ex- 
aggerated posture that 
comes from overexer- 
tion — the abnormal 
protrusion of the chest 
shown in the ' ' bantam ' ' 
attitude (Fig. 30) . The 
effect of this is to return the ribs and sternum toward the 
horizontal position, instead of allowing them to subside into 
the oblique positions that are an inevitable part of the broad- 
ening out of the chest in a normal, natural development. 
Obviously, this exaggerated lifting or protrusion continues the 
immature proportions, encouraging the depth from sternum to 
spine instead of the width of a natural, healthful chest. In 
other words, this attitude, whether assumed temporarily as an 

1 Kellogg, 81. 




Fig. 30. — Abnormal protrusion of the chest from 
overcorrection — the "bantam" attitude. 



THE CHEST 73 

exercise, or cultivated as an habitual standing position, tends 
to foster the ''persistent immature chest" which Dr. Woods- 
Hutchinson found to be typical of tuberculosis. 

The interference of this abnormal position with the move- 
ments of breathing is at once apparent. It has already been 
explained that the obliquity of the ribs favors their fuller move- 
ment in respiration, and such an influence as this position, which 
negatives the obHquity, can but tell unfavorably on the mobility 
of the chest walls in normal respiration. Moreover, in this 
exaggerated attitude the ribs are fixed in a distended position 
with what is called static contraction of the muscles. The 
extent to which the chest expands in respiration — its enlarge- 
ment and contraction with each breath — is^of greater impor- 
tance for the full and healthful functioning of the lungs than its 
simple girth. This expansion is a point of more importance with 
life insurance companies, in judging the physical condition of 
applicants for policies, than the extent to which the chest can 
be fixed in its largest possible attitude. 

Fothergill found that rigidity of chest, or lack of flexibility 
and expansion in the movements of breathing, was a concomitant 
of tuberculosis of the lungs, and others have corroborated this.^ 

That the overcorrected type of posture cultivates rigidity of 
the chest, and interferes with free, normal respiration, has 
been forcibly pointed out.^ 

It will be seen that girth of chest, a measurement taken with a 
tape straight around under the arms, cannot indicate whether or 
not the chest is broad or deep, or is held in good position. Chest 
girth, however, is one of the most important considerations in 
development, as, taken in proportion to total height, it is an 
indication of the relative size and power of the important organs 

1 Hutchinson, 68. =^ See Sargent, 122; Hall, 55. 



74 THE POSTURE OF SCHOOL CHILDREN 

within. After the nineteenth year the chest f^jirth should be equal 
to half the height.^ The effect of posture on trunk capacity was 
discussed in connection with the spine. It may not, however, 
be amiss to reiterate that only a chest in the normal position 
can give full room for the growth and functioning of the organs 
contained in the thoracic cavity. When the weight of these 
organs is thrust, by collapsed posture, upon the abdominal 
organs below, the ill effects naturally extend to those organs also. 

The following table of proportions in trunk capacity (sitting 
height and chest girth and index) should be prefaced with a word 
of explanation as to the general principles that govern the judg- 
ing of an individual by such figures. The modern trend in apply- 
ing physical measurements is to compare an individual with an 
elastic standard and not wholly with some arbitrary external 
type. That is, instead of saying that a child of a certain age 
should have a certain girth of chest, it is found more reliable to 
say that a child of a given age and height should have a chest 
girth that comes within certain maximum and minimum measure- 
ments, which are found to be compatible with normal growth and 
and health. For among a number of children of the same age, 
the height may vary greatly, and with it the girth and other 
measurements. Some, in other words, may be of a tall, thin type, 
and others of a short and stocky build, both of which types may 
be perfectly normal. It should therefore be understood that 
the figures given are for those found in the greatest number 
measured at the age mentioned, and that a moderate variation 
^ would not be abnormal. 

Another point in the use of measurements that is of much 
value is the comparison of an individual with himself by esti- 
mating the relative proportion of different parts. The illumi- 

iRall (G. S.), 55 ; Hall (W. S.), 57; Tyler, 140; Chaille, 17. 



THE CHEST 



75 



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Chest Girth 


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Sitting Height 
Percentage of 
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76 THE POSTURE OF SCHOOL CHILDREN 

nating significance of this has already been shown in connection 
with the chest index and proportionate size of the trunk. 

To sum up, the natural, healthful development of the chest is 
in the direction of proportionate increase in breadth rather than 
depth. While the depth should increase with growth, a pro- 
portionately flat, broad chest is better than a high, protruding 
chest, which, if it persist beyond early childhood, should be as 
much a cause for anxiety as the collapsed, depressed chest of the 
relaxed attitude. When the upper part of the spine is held 
erect, so that the general axis of the trunk makes one continuous 
vertical line (according to the vertical line test described in 
Chapter II), the chest will be in a perfectly normal position. 
An appearance of flatness or narrowness may often be caused by 
a forward position of the shoulders, and as such a shoulder posi- 
tion may depress and contract the chest by giving it too much 
weight to support, it becomes important that the shoulders be 
in a correct position.^ 

In all consideration of the chest, it should be borne in mind 
that the correct development and posture of the bony cage that 
contains the lungs is only one factor, however important, in lung 
development. Lung capacity is not synonymous with chest 
capacity, for one may have a large chest containing weak lungs 
or very limited respiratory movements. Healthful lung tissue, 
generously used through the demands of the system for oxygen, 
together with a well-established power and habit of action in the 
respiratory muscles, are essentials of a good physique. To en- 
hance the physiological action of the lungs through exercise and 
the stimulus of cold, fresh air, is a feature of lung development 
essential to any scheme of physical training. The present study, 
being confined to the subject of posture only, cannot enter upon 

that field. 

1 See Appendix, Note 7. 




Plate X. — William II, Prince of Nassau. 



Vandyke 



CHAPTER IX 
THE SHOULDERS 

The arms are each attached to two bones — the clavicle, or 
collar bone, in front, and the scapula, or shoulder blade, be- 
hind. These four bones are called the shoulder girdle. This 
shoulder girdle is fastened to the trunk by only one bony joint, 
where the clavicles join the sternum in front. This sterno- 
clavicular joint, with its two little sharp prominences, is what 
makes the bony protrusion in a thin neck |t the base of the 
throat. The scapulae, in the back, have no bony attach- 
ment whatever to the trunk, being entirely dependent for 
their position on the good tone and elasticity of muscles that 
draw them backward toward the spine, and inward, close to 
the chest wall and flat upon it. When one considers that nearly 
all occupations with the hands or arms are in front of the body, 
drawing the shoulders forward, it is not surprising that the 
posterior or back muscles, which antagonize this forward action 
and hold the shoulder blades in place, are kept unduly stretched, 
so that they lose their tone and allow the shoulders to droop 
forward. If, in addition to this, the spine be bowed over with an 
exaggerated curve in the dorsal region, the shoulders naturally 
slip forward still more, yielding to the pull of gravitation. 

Dr. Woods-Hutchinson found that with chests of round or 
barrel shape, which had not gained sufficiently in breadth, and 
had too great a proportionate depth, the shoulders were out of 
place, probably because of the rounded shape of the chest walls, 

79 



8o 



THE POSTURE OF SCHOOL CHILDREN 



which allowed them to slide forward as they could not do on a 
broad chest, flattened behind. The appearance of fiat-chested- 
ness in consumptives, he found, came from this forward position 
of the shoulders and not from the actual conformation of the 
chest which proved, on measurement, to be fuller in depth in 
such cases than it should be in normal development. Dr. Hutch- 
inson says : — ■ 

'' Briefly stated, flatness of the chest is merely an index of the 
position of the shoulders. Your flat-chested [tuberculous] individual 
is almost invariably round shouldered, and if you will simply take the 
trouble to . . . pull the shoulders back into something like their 
normal dorsal position, you will at once see, on looking down the 
front of the chest, that the actual shape of the rib-cage is rounded and 
barrel-like. Indeed, it is this very shape which has given rise to the 
abnormal position of the shoulders." 



With due allowance for other causes of forward shoulders, and for 
the voluntary protrusion of the chest that often comes from 
overcorrection before a child has learned to 
isolate the action of the shoulder muscles, this 
description applies to many non-tuberculous 
cases also. 

It will be seen that the action and position 
of the shoulder girdle, while it may be in- 
fluenced by the position of the spine, may 
^Ki i'- ~ f '"''^ff also be entirely independent of it. In study- 

blade seen from the j r- j 

front, with clavicle ^^„ posture in large numbers of children, this 

(collar bone) and ^ ^ ° 

top of humerus bccomcs vcry apparent, for it is not unusual 

(upper arm bone). 

to find a child who can hold the spine perfectly 
erect, and who is nevertheless decidedly round-shouldered. Just 
what, then, is the correct position of the shoulders, and what 
are round shoulders ? 




THE SHOULDERS 8i 

Obviously, the correct position for the shoulders, carrying as 
they do the weight of the arms, is one in which they are so bal- 
anced in relation to the line of gravity, that their tendency 
will be to tip the trunk neither forward nor backward. Authori- 
ties seem perfectly agreed that this position is well back of the 
line of gravity. This is plainly shown in the cut from Dr. 
Lovett's work (Fig. 9). Dr. Goldthwait says: — 

"The shoulder is slightly back of the lateral median line of the 
body, so that the weight is received largely upon the thorax, none of 
the muscles being in more than slight contraction, and the strain 
upon the posterior muscles, which must occur when the shoulder is 
held forward, is absent." ^ And again, the '' center [of the shoulders] 
is distinctly posterior to the center of gravity." ^ 

In the quadruped the scapulae are much •farther around on 
the sides of the chest walls (that is, toward the front or sternum) 
than in man, and their backward position, assumed with the 
erect attitude, has given a much wider range of movement for 
the arms at the shoulder joint. Their correct position in rela- 
tion to the chest is, then, one in which they have this range of 
movement. 

In the very little child with the barrel-shaped chest {i.e. 
up to four years of age) the shoulder blades, then very small 
in size, are often more on the sides of the chest, as in the 
quadruped. As the chest broadens out, it gets flatter in the 
back as well as in front, and the scapulae, by this time growing 
rapidly so that they are much longer, should swing around on 
the back until they lie fiat upon the rear wall of the chest,^ as 
shown in Fig. 20. 

In a very large percentage of cases, probably from the very 

1 Goldthwait, 48. 

2 Ihid. 

3 Woods-Hutchinson, 68, 69; Trettien, 138; Goldthwait, 48. 

G 



82 



THE POSTURE OF SCHOOL CHILDREN 



slight amount of exercise given the posterior muscles, this shift- 
ing of the scapulae until they lie flat on the back fails to take 
place, and as a result the shoulder blades lie obliquely on the 
sides of the chest, protruding behind in a deformity known as 
wing shoulder blades (scapulce alatce) (Fig. 32). This gives the 
appearance of a high, bowed-over back, even when the spine 
is not at all involved. The protruding point of the scapulae 
(inferior angle) may be easily felt behind, and in marked cases 

is plainly visible, even through 
the clothing. At the same 
time the outer tip or round 
of the shoulder is forced for- 
ward so that there is an un- 
naturally deep hollow on the 
front between the tip of the 
shoulder and the neck. The 
harm of this oblique or for- 
ward position of the shoulder 
blade lies, as before intimated, 

Fig. 32. — Wing shoulder blades on a child jn the fact that the Weight 
of six years of age. 

of the arms and the entire 
shoulder girdle is thrust too far forward, tending to drag the chest 
downward and prevent free action in breathing. When the 
shoulders are in this forward position, in order to keep the 
mechanical balance of the body the dorsal spine tends to bow 
outward behind in a curve greater than normal (kyphosis), 
the upper part of the trunk sinking backward with it. In this 
way the spine and chest are liable to participate in the faulty 
shoulder position, even if they have not been its cause. 

A forward carriage of the shoulders has, in many cases, been 
found a cause of acute pain in the shoulder and arm, similar to 




THE SHOULDERS 83 

that of neuritis and writer 's cramp, and often hard to distinguish 
from those ailments. The position leads to unnatural pressure 
on nerves, bursae, and other parts, acute inflammation and dis- 
tress resulting. Cases of repeated dislocation of the shoulder 
joint have also been traced to such malposition. In a detailed 
study of such conditions Dr. Goldthwait found that the correct 
(fiat) position of the shoulder blades on the back was the one 
that gave greatest stability to the shoulder joint, holding the 
various parts most evenly to their proper relation to each other. 
The drooping position with the shoulders forward he found to 
be the one of greatest instability as regards the parts and tissues 
around the joint, and from this instability arises the pressures 
and pain referred to above. ^ 

The correct position of the shoulder blades, then, may be 
determined by their flatness on the back, which carries the outer 
round or tip of the shoulder back of the median line of the body. 
The shoulders are placed in a balanced position by stretching 
the arms directly sidewise (not backward). Without this arm 
action, their position is often concealed by the clothing, and 
in studying several hundred cases to find an external landmark 
that could be readily used as a guide to detect an extreme 
forward position of the shoulders, the author found that in every 
case in which the trunk, including the neck, was perfectly upright, 
and the scapulae fiat on the back, the round of the shoulder came 
under, and, in a few cases, back of, the ear. This ear test has 
proved to be a thoroughly practicable criterion, readily used 
by any layman. Restated from a previous chapter, this test 
means that a line drawn upward through the middle of the 
round or tip of the shoulder should fall within, or back of, 
the ear. This is very readily demonstrated by placing the 

1 Goldthwait, 51. 



84 



THE POSTURE OF SCHOOL CHILDREN 



outer edge of the hand on the shoulder, with the fingers 
pointing toward the same point on the opposite shoulder, 
and toward the head, so as to show the relation of the 
shoulder to the ear. This is illustrated in Fig. 33. This test 

for a balanced posi- 
tion of the shoulders 
appears valid at all 
ages, even during the 
period of the cylindri- 
cal or barrel-shaped 
chest, for the author 
found it true in two 
hundred cases of chil- 
dren ranging from six 
months to seven years 
of age, and no excep- 
tions have been found 
in many thousands of 
cases of older chil- 
dren. Stated differ- 
ently, this ear test 
means that no normal 
shoulder blade can 
be flat on the back 
if the shoulder tip is 
in front of the for- 
ward border of the 
ear. That it is back 
of that border does not necessarily mean that the shoulder 
blades are in a perfect position and not in need of any special 
help, but where the clothing, as of school children, conceals the 




Fig. S3. — How to make the ear test for correct position 
of the round of the shoulder. 



THE SHOULDERS 



8S 



position, one may be sure of a faulty position from the ear 
landmark. This ear test should not be confused with the 
vertical line test for the entire body, from which it is entirely 
distinct : for a line showing the relation between the ear and 
the shoulder tip is to the rear of the weight line, falhng from in 
front of the ear to the forward part of the foot. 

Forward shoulders, with the 
wing protrusion behind, occur 
in so large a number of chil- 
dren that it would seem be- 
yond question advisable to 
forestall this fault of posture 
by definite exercise of the 
posterior muscles that coun- 
teract it. This will be dis- 
cussed more at length with 
the means of correcting pos- 
ture in general. The author 
feels, however, that the posi- 
tion of the shoulder blades is 
one of the most salient indi- 
cations that definite education 
and training for erect posture 
are needed for every child, entirely irrespective of correction 
in cases that have gone astray in the growing-up process. The 
trouble should be forestalled and prevented rather than cor- 
rected. 

Forward or round shoulders fall into two classes, like spinal 
curvature : the first, which may be called postural, being a condi- 
tion which the child can voluntarily correct by contracting the 
muscles that draw the shoulder blades together; the second, 




Fig. 34. — Wing shoulder blades seen from 
the side. 



86 THE POSTURE OF SCHOOL CHILDREN 

which is called resistant, or structural, forward shoulders, being 
a condition in which the shoulder blades cannot be put or 
held in position either by the child himself or by another. Cases 
of resistant forward shoulders are not very numerous, but among 
a large number of children are occasionally met with, and the 
orthopedic surgeon is not infrequently called upon to remedy such 
a defect. In such cases it is found that some of the Hgaments 
around the shoulder joint may be too short, or the clavicle too 
short, or the scapulae themselves may have grown rounded 
over the top, or be otherwise peculiar in structure.^ 

The chief cause, however, of resistant forward shoulders was 
found by Dr. Fitz,^ in an extended series of chnical and anatomi- 
cal investigations, to be an abnormal shortness in the serratus 
magnus muscle — a large muscle attached to the under side of 
the shoulder blade and then to the sides of the chest under the 
arms. The general direction of this muscle from the scapula 
is downward and forward, and its chief action is to pull the 
scapula (shoulder) forward. It does the main work in pulling 
the arm forward to dehver the ball in a throwing movement. 
Previous to Dr. Fitz' investigations, it had been supposed that 
the large muscles on the front of the chest, the pectorals, were 
responsible for this forward position of the shoulder blades, but 
there seems httle doubt that the serratus is mainly at fault. 

The treatment for resistant forward shoulders may vary from 
the use of braces or other means of stretching the muscles and 
ligaments by holding the shoulders in position, to surgical aid. 
In any event, with both structural and postural round shoulders, 
the muscles that antagonize the serratus and draw the scapulae 
toward each other and inward toward the spine (mainly the rhom- 
boideus major and minor and the trapezius) need to be strength- 

1 Goldthwait, 51, 53, 54; Taylor, 133. 2 pitz, 40. 



THE SHOULDERS 87 

ened by what are called shoulder-blade exercises. Without such 
exercise it is not reasonable to expect correction of even the 
postural cases in which the child has the power to voluntarily 
retract the shoulder blades. Until the muscles have been 
systematically trained to maintain the position, such a move- 
ment on his part is only the result of a temporary nervous 
stimulus. 

To ascertain the prevalence of resistant forward shoulders 
in very young children, and their possible relation to failure of 
the scapulas to swing around on to the back with the change in 
chest contours, the author examined the shoulders of one hundred 
and forty-eight children in the kindergarten and first year of the 
primary grades, ranging in age from five to seven years. The 
fiexibihty of the shoulders was tested by placing them in 
position with the hands, as shown in Fig. 48. If, being out 
of place to start with, they could be put in position, and if 
they could then be held there and voluntarily put there by 
the child, the shoulders were called flexible — i.e. non-resistant. 
Out of one hundred and forty-eight children examined, only 
four cases were found in which this could not be done, — 
four cases, that is, of resistant forward shoulders. That 
muscular training is needed to insure right shoulder positions, 
even with these very Httle people, was apparent from the 
fact that not infrequently the muscular tension holding the 
shoulders forward was so great (whether habitual or assumed 
during the examination could not always be determined) that 
some tact, and occasionally a gymnastic exercise with the arms, 
was necessary to get the needed relaxation. In these strong 
tension cases, however, if the right position was finally acquired 
so that it could be voluntarily assumed, the case was tabulated 
as one of flexible shoulders. 



8S THE POSTURE OF SCHOOL CHILDREN 

Mr. Trettien's investigation of changes in chest contours 
and shoulder-blade positions in infants is of much interest, and 
shows on both topics the general tendency toward normal devel- 
opment even at this early age.^ 

The literature on shoulder development is so scanty that it 
was a surprise, in a study of children for the prominence of the 
shoulder blades, to find almost invariably a more or less decided 
prominence of the scapulae in children from five to seven years 
of age (see Fig. 32), and the same fact in very mild form in a 
few cases of four-year-old children. By '' prominent " is meant, 
in this particular study of two hundred children, any protrusion 
of the inferior angle of the scapulae, however slight. Only part 
of this number were prominent enough to be classed as wing 
shoulder blades, though that this defect may be found in young 
children is apparent from the six-year-old subject in Fig. 32. 
Only when the scapulae reached the size and oblique position 
of the wing shoulder blades did the tip of the shoulder lie in 
front of the ear. 

From these facts it appears that the natural growth in length 
of the scapulae, while the chest is still in the cylindrical form, 
may lead directly into wing shoulder blades if the posterior 
muscles are not trained during this early period of growth. At 
the same time the serratus magnus muscle, which draws the 
shoulders forward, should be stretched with wide, swinging 
movements of the arms similar to those that Dr. Hutchinson 
recommends for widening the chest. 

There is probably no line of development in which the policy 
to be pursued in physical training is more clearly indicated by the 
facts of growth than this of the correct position of the shoulders. 
Such factors as changes in the shape of the chest wall, accompany- 

1 Trettien, 138. 



THE SHOULDERS 



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go THE POSTURE OF SCHOOL CHILDREN 

ing changes in the position of the shoulder blades^ the need of 
increased tension in posterior muscles as the shoulder blades 
undergo their rapid growth in length, and possible peculiarities 
in the structure of the shoulder joint and serratus muscles, all 
indicate the need for systematic training for all children. This 
training may well begin, even in the kindergarten and lower 
primary grades, with a large amount of the imitation plays 
and games in which the arms are stretched sidewise as wings, 
waving branches, walking beams, teeter boards, etc., and the 
first primary year is none too early for beginning straight, side- 
wise stretching movements of the arms at shoulder level, in 
formal gymnastic exercise. 

In training for correct position of the shoulders, the strength 
and tone of posterior muscles, the muscular sense of correct posi- 
tion, and correct muscular habits are, as in all other phases of 
posture, of fundamental importance. The fact that the poor 
position may be voluntarily corrected has led to an occasional 
opinion that the fault is due entirely to laziness and may be 
corrected by an exertion of will power. Though it is true that 
will power may do much, the question remains, as with any other 
phase of poor posture, — Why the need for will power ? Why 
do not all children grow correctly as some do ? When we can 
answer such questions in regard to mental and, moral develop- 
ment, we may be able to answer them for these phases of physi- 
cal development. Meanwhile, systematic training for the pos- 
terior muscles, and the cultivation of the right sense and habit 
of posture, can eliminate a large percentage of the postural 
cases, and possibly forestall many cases of resistant round 
shoulders. 

A word of caution is advisable against telling a child to " throw 
his shoulders back." .There never was a more misleading and 



THE SHOULDERS 91 

harmful direction for correct position. . It results almost in- 
variably in a throwing backward of the entire upper part of the 
trunk — one of the worst faults in bad carriage of the body. 
Practically every child can learn to draw his shoulder blades 
together, and that is what is really wanted and what he should 
be told to do. 

Every authority on the subject recognizes that round shoulders 
are not an isolated fault of posture. Like every other such 
fault, they act both as cause and effect, and "involve the whole 
body, from the base of support to the head." 

The restriction of breathing movements in child or adult by 
the forward carriage of the arms is in itself a final argument 
for correct position of the shoulders. ''I am convinced," says 
Dr. Hutchinson, ''that one of the most important factors in the 
respiratory development and capacity of the human chest is the 
extent to which the scapulae come to lie upon the posterior 
wall." 

The idea that a child will spontaneously outgrow round 
shoulders is not tenable. One has only to watch the army 
of young people passing out of our elementary schools, through 
the high schools, and entering higher institutions with round 
shoulders and protruding scapulae to see the fallacy of that idea. 
The number of adults whose poise, energy, and health are 
reduced by poor posture, are in themselves a sufficient proof 
of the harm of leaving to the chances of growth so important 
a matter. 



CHAPTER X 
THE PELVIS, ABDOMEN, AND FEET 

The pelvis has been called the bony floor of the trunk of the 
body, and such seems to be its service. It is a large, irregular 
circle, or girdle, somewhat like an open basin, to which the legs 
are attached, and the top of which forms the hip bones at the 
sides. It is attached to the spine at the sacrum, just below the 
last lumbar vertebra, so closely that it is tilted or moved with 
changes in the lumbar curve. Naturally, it acts in the oppo- 
site way, any change in the tilt of the pelvis affecting the curves 
of the spine (see Fig. 12). 

In its natural position the pelvis is tilted considerably down- 
ward and forward, but serves, nevertheless, as a very substantial 
support for the organs above it. When this obliquity is increased, 
the support is withdrawn, and an unnatural strain to keep the 
pelvic and abdominal organs in place is thrown upon the ab- 
dominal walls and also upon the ligaments that help to sus- 
pend those organs in place. Fully as harmful — perhaps even 
more so — is the result of tilting the pelvis in the opposite 
direction, with the posterior rim depressed and the ante- 
rior, or front rim, raised. This brings it into a horizontal 
position, in which the direction of the weight of the heavy ab- 
dominal organs above bears directly downward upon the pelvic 
organs. Dr. Goldthwait lays particular stress upon the harm 
of this position in both men and women. It is a position that 
comes from, or is associated with, the obliteration of the lumbar 

92 




ProctoT 



Plate XI, — Indian Warrior. 



THE PELVIS, ABDOMEN, AND FEET 



95 



curve in the second type of bad posture described in Chapter II 
("straight back")? and it forms one of the most pronounced 
faults of bad sitting positions, sometimes due as much to ill- 
shaped or ill-fitting furniture as to the fault of the sitter. 

The obliquity of the pelvis may also be influenced by relaxa- 
tion or overtension of the muscles that hold it upright on the 
thighs. It will be remembered that in the assumption of the 
erect position from that of ''all fours," the pelvis was drawn up 
into its right relation to the thighs by muscles on the back of the 
buttocks and thighs (the glutei 
and hamstrings). This mus- 
cular action is complicated by 
the fact that the powerful 
hamstrings, which run along 
the back of the thighs, are 
two-joint muscles; that is, 
instead of passing over just 
one point as do the majority 
of muscles, bending only that 
joint (the bend of the elbow 

by the biceps is a good illustration of a one- joint muscle), 
they pass over both the knee and hip joints so that relaxation 
or hyperextension of the knees may affect the tilt of the pelvis. 

Here we have at once another center of comphcated action 
and interaction, quite equal to that of the spine itself, and, indeed, 
so closely related to it that weak muscles at the knees or abdomen, 
by affecting the tilt of the pelvis, tell at once on the curves of 
the spine and so on the posture of the whole trunk of the body. 
Here again, also, overtension is as bad as relaxation. The 
knees sprung backward too tensely may throw the hips back 
too far, exaggerating the lumbar curve and tilting the pelvis 




Fig. 35. — The pelvis, or "bony floor" of 
the trunk ; also upper part of the femur 
(thigh bone). 



96 



THE POSTURE OF SCHOOL CHILDREN 



downward too far in front. This is a very difficult fault to cor- 
rect, and one not infrequently met with in children (Fig. 36)0 
The hamstrings at the knees, and some powerful muscles in the 
front of the pelvis that pull its front rim downward toward the 
thighs (the psoas and iliacus group), participate in this over- 
extension and have to 
be relaxed to correct it. 
The position may nearly 
always be detected by 
an abnormal, sharp pro- 
trusion of the buttocks 
behind, and an exagger- 
ation of the lumbar curve, 
so marked that it seems 
more an angle than a 
curve. A side wise tilt 
of the pelvis, acquired 
through a habit of stand- 
ing on one foot, is also 
extremely injurious.^ 

The abdominal mus- 
cles, involving, as they 
do, the position of chest, 

Fig. 36. — The pelvis tilted too much by springing 
the knees and buttocks (hips) backward. Note spinC and pclvis haVC 
the sharp angle in the hollow of the back. 

a great deal to do with 
good posture. The abdominal region, which, as regards its mus- 
culature, includes the front and sides of the trunk below the ribs, 
has no bones to support it in the way the ribs inclose the chest. 
Its walls are entirely of muscle in many layers, passing over the 
trunk vertically, horizontally, and obliquely in both directions, — 




^ Mosher, 99, 100, loi, 102. 



THE PELVIS, ABDOMEN, AND FEET 97 

a wonderful structure with as many directions to its strands as the 
most expert weaver could devise to give elasticity and strength 
to a textile on the loom. If these muscles are in good, elastic 
tone from proper use and exercise, they make a firm, wall that 
helps to hold in place the great organs of the trunk ; if allowed 
to become flabby and relaxed, however, or if drawn out of shape 
by improper dressing, these abdominal muscles, having no bony 
framework to reenforce them, fail to support the organs within 
and allow them to sag out of place. The correct contours of the 
abdomen and the front of the body will be discussed in consider- 
ing the subject of dress ; suffice it to say here that there is nothing 
of greater importance for the posture of the body, for the posi- 
tion of the organs of the trunk, for the circulation of the blood 
through those organs, or for other general conditions that make 
for their proper functioning, than strong abdominal walls. There 
is no part of the body that suffers more from the relaxation of 
prolonged or poor sitting positions, or from the distortion of 
dress. There is none for which systematic, daily exercise is 
more needed.^ 

And finally — and there is no reason except that of beginning 
with the most obvious elements, why they should not have 
been mentioned first — finally we come to the feet, the base of 
support of the whole structure. The feet have a posture of their 
own to be considered, in addition to the exact place in them that 
should bear the weight line of the body. 

A generation ago children were taught to turn their toes out- 
ward, and for a majority of people a straight forward direction 
of the foot was equivalent to ''toeing in." The distinction is 
not as generally understood to-day as it should be, though the 
the prevalence of fiat foot (broken or fallen arches) — one of 

1 Harvey, 62. 
H 



98 



THE POSTURE OF SCHOOL CHILDREN 



the results of excessive toeing out — is leading to a painful 
awakening on the subject. From fifty-seven to sixty-one per 
cent of the cases of fiat foot are found between the ages of ten 
and twenty-five, the larger number of these being between six- 
teen and twenty-five/ which shows that young people need 
especial care for the hygiene of the foot during the time when the 
neuro-muscular system is immature, and 
weight is rapidly increased. 

The normal foot has a natural arch in its 
structure, between the heel and the ball, 
which shows as a hollow on the inner side. 
After a child is six years old (and usually 
before) an impress of the bare foot on the 
ground shows that the hollow does not touch 
the surface (Fig. 37). When the toes are 
turned broadly outward, the ligaments that 
hold this arch up are put under such a strain 
that in a very large number of cases they 
yield, allowing the inner hollow to flatten 
out so that it touches the ground. This 
condition may also be detected by the ankle 
joint on the inner side which, in flat foot, 
becomes unduly prominent, for the weight of the body is 
thrown too far inward, instead of bearing directly down- 
ward through the center of the heel. This condition of 
broken arch is a very painful one, its effects often not being 
confined to the region of the foot, but involving strain upon 
the ligaments throughout the leg. This condition of flat foot 
is pathological, like lateral curvature of the spine, and should 
as promptly have medical diagnosis and treatment. The 

^ Whitman, 143. 




Fig. 37. — Normal im- 
press of adult foot 
and normal outline 
as inclosed in geo- 
metric boundaries. 
{From Whitman's 
" Orthopedic Sur- 
gery," by courtesy 
of Messrs. Lea &* 
Fehiger.) 



THE PELVIS, ABDOMEN, AND FEET loi 

weight ; at the same time one should be able to feel that the ball 
of the foot is pressing firmly upon the ground. Many people 
carry the weight too far backward, and directions for swaying 
the body forward from the ankle are necessary in almost all cases 
of postural correction. 



CHAPTER XI 
POSTURE IN ADULTS 

To stand erect means fully as much for the health and effi- 
ciency of an adult as it does for a child. The effects are quite 
the same as regards the functioning of the organs, their possible 
displacement, or the expenditure of energy required for main- 
taining the erect position. Indeed, it may mean even more, when 
endurance comes to be taxed by the demands of adult interests 
and occupations. 

Whether or not a person be standing in the correct position 
may be judged for the adult, as for the child, most simply and 
directly by the vertical line test. Re-stated, that means that 
a vertical line dropped from in front of the ear into the forward 
part of the foot should parallel the apparent vertical axis or 
diameter of the trunk, and of the neck and head taken together. 
In poor standing of the relaxed types — the types most often 
met with — the axis of head and neck form one Hne which slopes 
downward and backward, the apparent axis of the trunk another, 
which slopes downward and forward, and a third direction is 
necessary to carry the line down into the forward part of the 
feet. In the correct position, the shoulders should be set squarely 
across the back, so that they are flat and the shoulder blades do 
not protrude. A vertical line drawn upward through the round 
of the shoulder should fall within the ear or behind it, the 
exact point varying in different individuals. The hollow in the 
back should not be excessive, — a fault that may be detected, 

I02 




Gainsiorough 

Plate XII. — The Morning Walk. Squire Hallett and his Wife. 

{From the collection of Lord Rothschild. By courtesy of Brauii and Co.) 



POSTURE IN ADULTS 105 

according to its cause, by a forced distention of the ribs and 
puffing out of the chest in front, a stiff arching backward of the 
buttocks behind, or a sagging backward of the upper part of 
the trunk. This latter fault cannot occur when the axis of the 
whole trunk is vertical. The feet should have the toes directed 
straight ahead, and the weight should fall on the middle or for- 
ward part of the foot. 

The normal chest in an adult is much broader (from side to 
side) than it is deep (from front to rear), the index, or pro- 
portion of depth to breadth, being from seventy to seventy-two 
per cent. The girth of chest after nineteen years of age should 
be, according to competent authorities, about half the height — 
certainly not less. The terms ''full chest" and "high chest" 
do not mean that depth should exceed breadth, or that there 
should be more than moderate slope outward of the sternum. 
This slope of the sternum is slightly greater in adults than in 
children of eleven to fifteen years of age, but never forced out- 
ward by a muscular tension that sets the ribs, or tips the trunk 
backward. The simple movement of bringing the upper part 
of the trunk forward so that the chest is over the toes, puts the 
spine and chest in the correct position. The term "chest high," 
then, means, for a naturally developed chest, simply, chest not 
collapsed. One looks in vain through Greek statuary for the 
strained, puffed-out chest of the exaggerated attitude. Greek 
gods and heroes, no matter in what moment of action or relaxa- 
tion they may be depicted, have the broad, fiat chest, with the 
moderate outward slope of the sternum — never the "chesty" 
exaggeration that correct attitude is sometimes interpreted to 
mean. Indeed, all of the points that have been given in fore- 
going chapters for the correct carriage of chest, head, shoulders, 
and other details, are amply illustrated in Greek statuary. 



io6 



THE POSTURE OF SCHOOL CHILDREN 



Wrestlers, warriors, and gods, quiescent or active, all show the flat 
shoulder blades on the back, and the perfect development and 
relation of parts that mean good posture. A Venus with wing 

shoulder blades, or an Apollo 
with puffed-out chest, can be 
found only in the sketches of 
the modern cartoonist. In a 
study of statuary in the Early 
Greek room of the Boston Mu- 
seum of Fine Arts, which contains 
casts from 500-600 B.C., and in- 
cludes an age of high Spartan 
development. Dr. Goldthwait 
found there was not a single cast 
or reproduction that did not 
show the body so poised that 
the greatest efficiency of the 
organism would be possible. Of 
Fig. 39 he says : — 

^' While the modeling may not 
equal that of the later Greek period, 
the poise is all that could be de- 
sired. The head is erect and in 
such balance that all of the mus- 
cles must be in easy contraction, 
making possible any movement, 
forward, backward, sidewise, or 
with any combination, with the 
greatest ease and with the least possible waste of energy. The 
chest is high, allowing the fullest freedom of action of the thoracic 
organs. The shoulders are erect, in which position all of the 
muscles are in easy contraction ready for immediate function 
with the least effort. The trunk is so in balance that no group of 




Courtesy of Dr. Goldthwait 

iiG. 39. — Correct standing position in 
a Greek statue of the period of highest 
Spartan development. 



POSTURE IN ADULTS 107 

muscles or part is strained, but action with the minimum of waste 
is possible, while the visceral support and function is maintained 
with the least effort. So, also, with the legs, there is no strain, but 
every part is ready for full duty with the least waste in either time or 
energy. The greatest amount of general fitness is suggested by the 
figure, and this applies not only to that which is physical, but to the 
spirit or the purpose of the individual. In every part, the body, the 
mind, and the spirit, the figure suggests readiness and efficiency." 

Notice that the vertical line test applies perfectly to this en- 
tire figure, as does also the ear test for the position of the shoulders. 
It is noticeable, too, that, as in all Greek statues, the perfectly 
erect position does not call for static distention of the ribs. 
No strain of this kind appears in any part of the figure, al- 
though the ''high" chest has a slope of sternum of thirty de- 
grees, five degrees above the maximum normal for an adult, 
which would be excessive for a child during the natural ''flat- 
chested" age. 

The term "flat back" is sometimes used to indicate a desir- 
able contour for the back, but never, by an expert, in the sense 
of obliterating the natural curves. Like the "chest high," this 
term so used means a back either flat over the shoulders, or show- 
ing only a normal hollow in the lumbar region as distinguished 
from the exaggeration of lordosis. 

Good posture in child or adult means the relation of parts in 
habitual attitudes. No one should maintain an absolutely erect 
position during all the waking hours, even if the ordinary occupa- 
tions of life allow it. But whenever the erect attitude is assumed, 
for standing, walking, or sitting, whether the hands or eyes be 
actively engaged or not, the body should conform to the vertical 
line test. Temporary changes of position are not only advisable 
but necessary, for the good tone of the muscles that hold the body 
erect may be maintained only by such relief and variations in their 



io8 THE POSTURE OF SCHOOL CHILDREN 

activity. Nothing is more subversive of good habits of posture 
than long standing, and any one whose occupation calls for 
this should vary the base of support by the standing positions 
described for recitation in school work on page 261. 

Habitual positions, whether required by one's occupation 
or assumed as an unconscious habit, are what mold the body 
and become ingrained in the muscular sense, confirming or 
vitiating the natural sense of bodily equilibrium. These habits 
require study and correction if wrong, or continued cultivation 
if right. Fatigue comes less readily in correct posture, and the 
energy spent through unconscious muscular action in main- 
taining a bad position is available in good posture, for other uses. 
In good posture, also, better circulation, respiration, and diges- 
tion keep the stores of energy and sense of well-being at a higher 
level, and the efficiency and even the spirits of the individual 
are thereby placed on a loftier plane. 




Gatrisoorougn 



Plate XIII. — Mrs. Sheridan. 
{By courtesy of Br aim and Co.) 



CHAPTER XII 

ERECT POSTURE IN SITTING, STANDING, WALKING, AND 

STAIR CLIMBING 

Under the conditions of our modern civilization, the aver- 
age person, whether child or adult, spends more hours a day in 
sitting than in standing or walking. The carriage of the body 
becomes, therefore, as important in sitting as in any other atti- 
tude, and all that affects its posture and the^consequent position 
of the viscera holds as truly in a sitting position as in standing. 

There are three correct modes of sitting, two active and the 
other resting. In the active positions the trunk is perfectly 
erect, or inclined forward ; in the resting position it is reclined 
backward. Many people make the mistake of including in the 
act of sitting a relaxation or collapsing of the body forward, with 
a crease at the waist. The interference which such an attitude 
makes with the position and work of heart, lungs, and digestive 
organs is anything but restful, — a fact shown by the relief that 
comes from occasionally stretching upward to the right position 
and drawing in a long breath, — the indication of "air starvation " 
noted by Dr. Kellogg. 

A fundamental direction for correct sitting is to push back 
in the chair as far as possible before leaning backward. Shding 
down in the seat tilts the pelvis into its most harmful position, 
and should never be allowed. 

All leaning forward in a sitting position, as in formal con- 
versation or at the dining table, should be from the hips, not 

III 



112 THE POSTURE OF SCHOOL CHILDREN 

from the waist. A perfect sitting position of this kind is shown 
in the attitude of Mrs. Sheridan, in Gainsborough's famous por- 
trait (Plate XIII). Both of these sitting positions — the leaning 
forward and the perfectly erect attitude — require the same 
work of most of the muscles that hold the spine erect that is 
needed of them in the standing position, except that much of the 
pull of gravitation is removed in sitting because the center of 
gravity is closer to the base of support (the chair). The un- 
certainty of equilibrium is also less in sitting than in standing, 
owing to the wider support afforded by the pelvis as compared 
to the feet. The relief of sitting comes not only through releas- 
ing the strain of the voluntary muscles that hold the body up- 
right, but also through the lessened demand on the heart, which 
does not have to send the blood climbing through so long a dis- 
tance against gravitation as in standing. 

When one wishes to rest the muscles that hold the trunk 
erect in the sitting position, the entire trunk should be reclined 
backward against the back of the chair or other support. This 
accompHshes the object without any interference with the 
broad, open chest if the chair back be of the right shape. This 
reclining should be done without sliding downward and forward 
in the seat. 

The height and shape of chairs has much to do with sitting 
positions. It is impossible in many to assume good posture. 
The chair should be of such height that the feet may rest fully 
on the floor. The lines that affect the back are also of great 
importance. These are discussed with home and school hygiene. 

Sitting on one foot is a habit with many girls, which, if habit- 
ual, may produce lateral curvature of the spine. 

Prolonged standing is one of the most fatiguing things that 
can be required. Walking is far less fatiguing, and within 



SITTING, ETC. 113 

reasonable limits has an exhilarating effect, for the muscles are 
kept alternately contracting and stretching, and the circulation 
is more or less stimulated. In prolonged standing, on the other 
hand, muscles, ligaments, and heart are all put on an unrelieved 
strain that may lead to permanent weakening unless all possible 
means be taken to avoid such a result. Broken or weakened 
arches in the feet are most common among policemen, car drivers, 
and others who have much static standing ; these and all other 
faults of posture are found abundantly among shop girls and 
others whose vocations call for long standing. Instinctive 
methods of relief consist mainly in shifting the weight and posi- 
tion as much as possible. But out of this is apt to grow a 
habit of standing too much on the same foot, especially with a 
sidewise inclination, which is one of the worst faults that 
comes from prolonged standing. Relief should be found in 
the positions illustrated by Dr. Mosher, and explained in the 
chapter on school hygiene. 

Housework, with its comparatively slight moving about, is 
almost equivalent to standing, and the result of it is quite the 
same, a very considerable percentage of cases of fiat foot coming 
from house workers.^ 

The habit of boys of standing and walking with hands in the 
pockets leads usually into a slouching position of the worst pos- 
ture, especially if the pockets be deep (Fig. 40). Relief from 
weight of the arms may much better be had from catching the 
fingers in the belt, than from putting the hands in the pockets. 

Walking is one of the best of exercises if the dress be such 
as to allow proper freedom of motion. It is correct for the 
heel to touch the ground first, but if the weight be poised well 
forward, it will be transferred very quickly to the ball of the 

1 Woods-Hutchinson, 72. 
I 



114 



THE POSTURE OF SCHOOL CHILDREN 



foot, so that the placing of the foot seems almost fiat-footed. 
When the weight is not poised well forward, the heel comes down 
with such force that the elasticity of the step is largely lost, 

being replaced by a harmful jar 
that is transmitted throughout 
the body. Such a backward car- 
riage of the weight means in- 
evitably that pelvis and spine 
are not in right relation to each 
other. 

The idea that in walking the 
toes should touch the ground first 
is one of the fallacies that has 
grown from the wearing of high- 
heeled shoes ; with these there is 
no alternative to such an artificial 
use of the foot. A dainty and 
elegant use of the foot avoids 
thrusting the toes noticeably up- 
ward when the foot is extended 
for a step in walking, but they 
should not touch the ground first. 
The toes should point directly 
forward in the ''straight-foot'' 
position. 

A perfectly erect carriage of 
the trunk of the body is one of 
the essentials of graceful as well as healthful walking. There 
must always be some mechanical reaction to the movement of 
the foot and leg/ as in the slight swing of the arms at the sides 




Courtesy of Dr. Goldthwait 

Fig. 40. — The slouching position cul- 
tivated by .carrying the hands in the 
pockets. 



1 Marey, 95; Pettigrew, no; Schafer, 159. 



SITTING, ETC. 115 

(never across the front of the body). This reaction is greater 
the longer the step, as may be seen in the swing of body or arms 
in certain forms of skating. If this movement of the arms be 
restrained, the reaction will show in some twist of shoulders or 
hips. These matters will take care of themselves if the poise 
and dress be correct, and with those two elements right, practice 
in the mere act of walking in long, interesting walks in which 
there is no thought of detailed movements, is the best teacher 
of grace. 

Stair climbing, both as to its methods and effects, is one of 
those common activities about which cling many traditional 
fallacies. Stair climbing may be an excellent exercise, stimu- 
lating to good circulation and deep breathing. To anyone in 
normal health it can do no harm if not carried to excess. The 
point of departure comes when the tax upon the heart is exces- 
sive, and for this reason the chmbing of many fhghts of stairs 
many times a day should be avoided, even for a person in normal 
condition. A reasonable amount of stair chmbing, however, 
may be looked upon as good exercise for those in normal health, 
if the erect posture he maintained throughout. This is the essential 
point in stair. climbing (Fig, 41). The lifting of the whole weight 
of the body by the large muscles of the legs and thighs will stim- 
ulate heart and lung action very quickly. This is an inevitable 
physiological consequence — a perfectly natural result — and, 
indeed, the effect that makes stair chmbing a good exercise. 
If the trunk be bent forward at the waist, however, in any of the 
cramped or collapsed positions of poor posture, the action of 
heart and lungs is quickly embarrassed, and distress and undue 
fatigue at the time and afterward are the result. There should, 
therefore, be an erect carriage of the trunk as a fundamental 
requisite to stair chmbing. Even with this posture, an extended 



ii6 



THE POSTURE OF SCHOOL CHILDREN 



climb will result in a quickening of the breath. Any one not 
burdened with excessive flesh should be in such good condition 
(training) that at least one flight of stairs could be climbed 




Fig. 41. — Erect carriage of the body in stair climbing. 

without noticeable embarrassment of respiration. When the 
climbing of several flights is necessary, one should not hesitate 
to stand or sit and rest a moment in transit. 

The way in which the foot is placed upon the stairs is a matter 
that usually takes care of itself instinctively. This is another 



SITTING, ETC. 117 

of the subjects of traditional dogmatism, and, like all traditions, 
is subject to many variations. The truth is, that the mechanics 
of stair cHmbing have not received as much technical study as 
the mechanics of standing and walking, but the most sahent 
features are obvious. Mounting a flight of stairs means carry- 
ing the body in two directions — upward and forward. If the 
depth of each step (from front to rear) be slight, there is very 
little need for a forward tilt of the body. If it be great, there 
is the same need for tilting the body forward that there is in a 
long step in walking. This tilt should be from the ankles as in 
walking, or from the hips, and never from the waist. If the 
step be very high or deep, or the climber very heavy, the lever- 
age on the forward knee may need to be eaced by a forward tip 
of the body from the hips — here again, never from the waist. 
Whether the whole foot should be planted on the advance step 
or not is a matter that may well be left to instinct, for this, too, 
may vary with the height and depth of the step and the weight 
of the individual. In descending stairs, however, the toe should 
touch first, so as to lessen the work of the ''hold back" muscles, 
and save jar to the body. 

Finally, it should be remembered that no position, sitting, 
standing, or lying down, should be maintained long without 
change of attitude. This applies to both children and adults, 
but especially to children, whose natural restlessness is one of 
the fundamental instincts of nature to secure for them the motor 
activity and the rehef from strain that have a deep physiologi- 
cal and educational significance. The cKmbing instinct of very 
Httle children is a part of this, and should be respected and pro- 
vided for, as was done some time ago in the invention of a 
''climbing high chair." It is not meant that children should 
make themselves disagreeable, or fail of control through indul- 



Ii8 THE POSTURE OF SCHOOL CHILDREN 

gence in restlessness, but that an undue suppression of it is a 
positive harm and even cruelty to the child. 

Good posture, then, does not mean one unvarying attitude 
held through all the waking hours. It means the habitual car- 
riage, and especially that when the body is in the erect attitude 
it shall be truly erect. Transitory twisting and turning, stoop- 
ing and bending, if not long maintained, but only for temporary 
relief, are nature's own way of relieving the strain of man's last 
and proudest achievement, erect carriage of the body. 




Titian 



Plate XIV. — A Daughter of the Artist Strozzi. 



CHAPTER XIII 

HOW TO CORRECT POOR POSTURE: WHAT MAY BE DONE 
AT HOME; TRAINING THE MUSCULAR SENSE 

Nagging is the worst possible way of correcting posture ; 
and yet from time immemorial it has been a method to which 
almost every child whose posture has had attention has been 
subjected. The foregoing chapters have failed of their purpose 
if they have not made plain that nothing could be more unjust 
or even cruel to a child than to expect him to correct, solely by 
spasmodic effort of his will, faults incidental to the shape, weak- 
nesses, and development of his body in the process of growth. 
Systematic training, especially designed to cultivate the right 
contours, to strengthen weak muscles, and to estabHsh correct 
neuromuscular habits, is the only proper way of achieving cor- 
rect posture ; and, more than that, it is the only effective way of 
reenforcing and training the will power that he must exert to 
establish the right habits. 

The word ''systematic" is the keynote in this training, and 
because of its organized opportunity for systematic work, and the 
appeal which it can make to individual and class pride and am- 
bition, the school has a great opportunity for such training. 
As in all other lines of school work, however, the cooperation 
of the home is essential if the best results are to be obtained. For 
cases needing correction, this help may well he in the direction 
of additional home exercise, and some regular method of en- 
couraging the positions which the school is trying to estabhsh. 
Certainly, the efforts the school is making in these directions 



121 



122 THE POSTURE OF SCHOOL CHILDREN 

should be clearly understood by parents, and followed up by 
them in any way suggested through cooperation with the school 
authorities. Probably the greatest need that the school finds 
for help from the home is on the side of hygiene, including 
matters of dress, conditions for home study, proper amount of 
sleep, nutrition, and home tasks, and other matters that will 
be dwelt upon in the chapter on home hygiene. Methods of 
correcting posture at home will be outlined in the present 
chapter. 

First of all in the correction of posture comes the training 
of the muscular sense of the correct position. By this is meant 
Hterally how it feels to stand correctly. Usually we are not 
conscious of the sense of position, but without going into any 
of the subtleties of discussions on the matter it may be said at 
once that there exists a subconscious sense of the position of the 
different parts of the body, and also a distinct instinct for equi- 
librium. The Httle child, learning to stand erect for the first 
time, is largely helped by these powers, though at that time they 
are weak and undeveloped. The sense of equilibrium, which 
controls his muscular adjustments, leads unconsciously in all 
of his movements and activities to the mechanical reactions, 
whereby the line of gravity is kept within the base of support 
and the body is saved from falling. Reference has been made 
to changes in the natural curves of the spine whereby a change 
of position in one part is counterbalanced by changes in other 
parts. Dr. Lovett also attributes to this sense of equilibrium 
the estabhshment of many lateral curves of the spine, especially 
those that are usually called secondary or compensatory curves, 
which show an instinctive effort to keep the shoulders and pelvis 
parallel with each other when one or the other is thrown out of 
position. 



HOW TO CORRECT POOR POSTURE 123 

The habitual position in which the body maintains the erect 
attitude, whether the posture be good or poor, becomes 
ingrained, as it were, in the nervous system, so that a habit is 
estabhshed of associating that particular combination of muscu- 
lar tension with the erect position. To use a familiar simile, 
the muscles become molded to this particular shape, just as a 
glove becomes molded to the shape of the hand, and main- 
tains the form when all conscious influence is withdrawn. It 
feels right to stand in this habitual posture, and to change to 
a new posture, however much that may release cramped breath- 
ing movements and improve the position and action of the or- 
gans, will seem strange and unnatural. This feeling of position 
comes from the muscles in whole or in pait, and the first step 
in correcting posture is to train discrimination in this feeling — 
this muscular sense of position — so that the person concerned 
will know by this feehng alone whether or not he is in the cor- 
rect position, and will be able to assume it at will. 

Some children can place themselves in correct posture by 
following a few simple directions, but in many children the 
muscular power and control for this voluntary correction are 
at first lacking, and it is necessary that they be placed in position 
by some one else with what are called manual corrections until 
the voluntary power be acquired. The best and simplest method 
which the author has found for getting the first-mentioned class 
of children into correct standing position, is to have them stretch 
the arms directly sidewise at shoulder level, with the palms 
turned downward, and, holding the arms there, sway forward 
from the ankles so that the weight of the boy is nearly or quite 
over the balls of the feet, not, however, rising on the toes, but 
keeping the heels on the ground (Fig. 42). An effort to draw the 
neck backward (chin inward) may be necessary to bring the neck 



124 



THE POSTURE OF SCHOOL CHILDREN 



into an upright position. Keeping head, chest, and shoulders 
just as this places them, the arms should then be dropped to the 
sides. This will leave the entire body in the correct standing 
position. The advantage of this method is that it is synthetic, 
treating the body as a whole by taking advantage of the natural 
mechanical reactions whereby, if the upper part of the trunk 

be placed in position, by 
swaying the weight for- 
ward and stretching the 
arms sidewise, the rest falls 
naturally into line. This 
has been found much more 
easily to accomplish the 
purpose than the analytic 
methods often used which 
call attention to details 
entirely, such as ''Head 
up, chin in, chest out, hips 
back, weight forward." 

Fig. 42. — Stretching the arms sidewise and sway- i -i j n 

• ing forward from the ankles to get in good posi- While a chlld may WCll 

tion. {From Bancroft's "School Gymnastics, -, , • 4. 'j. • 

Free Hand," by courtesy of Messrs. D. C. Heath knOW tliese pOintS, it IS 

very difficult for him to 
isolate the action of different parts of the body called for 
by such analytic directions. Especially for different sections 
of the trunk, as chest, hips, abdomen, etc., the habitual as- 
sociation of muscular groups is such that they will act to- 
gether synthetically ; whereas, if the different parts be corrected 
separately, all sorts of difficulties of adjustment will be en- 
countered. 

If a child's own motor faciHty be not sufficient to achieve the 
correct position in the way described, he may be placed in posi- 




HOW TO CORRECT POOR POSTURE 



125 



tion with assistance. For this, the first and chief point of at- 
tack is the upper part of the trunk, which in all relaxed types of 
poor posture will be found to have sunk backward. The prob- 
lem in all correction of this fault is to get this part forward with- 
out forcing the ribs and sternum forward and outward in the 





Fig. 43. — Thj hands placed 
for pushing the upper part 
of the trunk forward. 



Fig. 44. — The corrected position of 
the trunk. 



exaggerated ''bantam" attitude — an overcorrection into which 
a child without muscular facihty is very apt to fall, especially 
if he try to correct his position unaided. In assisting a child 
into position, the spine needs to be treated as though it had 
but one joint, and that in the small of the back (lumbar curve), 



126 



THE POSTURE OF SCHOOL CHILDREN 



— the point where weakness has allowed the settling backward. 
To accomplish the correction, one should stand at the child's 
side, so as to see him in profile, and place one hand just below 
the belt in front to serve as a steadying point of resistance ; with 

the other hand back 
of the shoulders be- 
hind, the upper part 
of the trunk should 
be pushed forward 
(Figs. 43. 44)- When 
this is done, the 
spinal curves (with 
the possible excep- 
tion of the neck) , the 
chest, and the pelvis 
will all fall into cor- 
rect position. This 
whole movement 
really amounts to 
bringing the chest 
forward, but the 
method of doing it 
confines the action 
chiefly to the spine, 




Getting a child to relax distended ribs. 



Fig. 45. 

and avoids the artificial distention of the ribs that comes from 
efforts to lift the chest or protr,ude it forward. 

A distention of the ribs requires an entirely different method of 
correction. This fault comes from too much effort — too much 
tension in the muscles — and should be corrected by relaxation. 
To place one's hands on the distended ribs and ask the child to 
"Relax," or to ''Let go," or not to "Try so hard," will usually 



HOW TO CORRECT POOR POSTURE 



127 



accomplish this (Fig. 45). Overextension may always be de- 
tected by an extreme hollow in the back, and whenever such a 
fault is found, it should be corrected as just described. 

If the head (neck) cannot be placed in position with a vol- 
untary effort, the chin should be pushed inward as shown in 
Fig. 46 ; this will be found 
to straighten the neck. 
Some children lack en- 
tirely at first the power 
to retract voluntarily the 
neck in this way. 

The shoulders may still 
need some assistance to 
get them into the correct 
position. Judging these 
by the ear test and other 
indications described in 
Chapter II, if the shoul- 
ders be found too far for- 
ward, and the lower angle 
of them protruding behind, 

the cases will be very rare Fig. 46.— Pushing the chin inward to correct a 

forward slope of the neck. 

in which they may not 

easily be drawn into place by standing behind the child and 
placing the hands as shown in Fig. 48. The thumbs are spread 
out over the back and serve to give the slight purchase needed 
to draw the shoulder blades inward toward the spine. Here 
again the child will probably be able at once to hold the 
position without help, and to lose and resume it himself. Be- 
cause of the close association of muscular action involved 
in this movement of the shoulder blades and the overexten- 




128 THE POSTURE OF SCHOOL CHILDREN 

sion of the spine, this shoulder movement is sometimes ac- 
companied with the exaggerated posture before noted. With 
some tact and patience the two movements (of shoulder blades 
and spine) may be isolated, and the correct position of shoulders 
assumed without overdoing the attitude of spine and ribs. 




Fig. 47. — Improper posture: on the left, overcorrection by swaying too far forward; 
center and right, relaxed poor posture. 

Having acquired the correct position, the child should learn 
through a little drill to lose and assume it voluntarily. This 
he should be asked to do in a deliberate manner, with no effort 
at haste, for in very rapid action his movements are not only 
inclined to be less accurate, but he will be less likely to discrimi- 
nate carefully between the feeling of the old and the new posi- 
tions. Later, he can take this posture drill quickly on signals. 



HOW TO CORRECT POOR POSTURE 



129 



If, after relaxing into the old habitual position, he cannot resume 
accurately the corrected position, he should again be helped 
into it. This drill on losing and resuming the good position 
should be repeated 
several times in suc- 
cession. It is the 
foundation for any 
further work, and too 
much cannot be said 
of its importance. 
There is no use in 
trying to strengthen 
any weak muscles 
connected with poor 
posture unless the 
child can assume this 
correct position as a 
basis for exercising 
them, for otherwise 
the old habits of co- 
ordination assert 
themselves during the 
performance of the 
exercise, and its cor- 
rective effects are lost. 
With some children 
patient help in assuming the right position is needed on suc- 
cessive days, but most children will acquire in a few minutes 
the power to put themselves in position. 

Two faults may need to be guarded against in this correction 
of position — a bending forward at the waist or hips instead 




Fig. 48. — How to place the hands for drawing the 
shoulder blades backward into position. 



130 THE POSTURE OF SCHOOL CHILDREN 

of swaying forward from the ankles, and the overcorrection with 
fixed and distended ribs, which cultivates lordosis (exaggerated 
lumbar curve). If there be any tendency to bend forward at 
the waist or hips, instead of swaying forward from the ankles, 
it may at once be overcome by asking that the whole body be 
kept firm as though in one piece, with no joints except at the 
feet as the weight is swayed forward. Sometimes the stretch- 
ing sidewise of the arms will also help to overcome this tendency 
to bend forward at the waist or hips. 

With such a power of voluntarily assuming the correct posi- 
tion, however transitory may be the ability to hold it, one has 
a foundation on which to rear a structure of strong muscles and 
the habit of their proper coordination in any of the activities 
of life. Without this power, any such training is worse than use- 
less ; it serve-s only to accentuate and to cultivate the old faults. 

To remind a child of the correct position at times is usually 
necessary, but on the way in which that reminder is given will 
depend its being a mere irritating nagging or a true training. 
By systematic association with certain times and places, such 
reminders may recall him to the correct position with sufficient 
frequency to form a habit if, meanwhile, the weak muscles he 
properly trained to do their part. In the discussion of school 
training for posture there are described methods of establishing 
habits of posture, under school conditions, that have substituted 
motive on the part of the child for the old, ineffectual nagging, 
that was as distasteful to the teacher as to himself. For home 
use the writer would suggest that the assumption of the correct 
posture be made a part of certain, regular procedures, — for in- 
stance, of dressing in the morning. An old Civil War general 
was in the habit of having his children line up for inspection 
of their toilets before sitting down to breakfast. In true military 



HOW TO CORRECT POOR POSTURE 131 

fashion he passed them in review, each saluting as he passed down 
the hne — a half playful element of ceremonial that made almost 
a game of this inspection of finger nails, hair, neckties, shoes, 
and other details of dress. Any one found lacking in these re- 
quirements was obliged to make good the deficiency before com- 
ing to breakfast. In this happy but serious manner, all nagging 
was done away with, and a systematic method substituted. 

The suggestion is one that might be apphed in various ways 
to the assumption of correct posture. Starting for school, for 
instance, might well be an occasion for inspection of posture, as 
well as of toilet, especially if books are to be carried. The habit 
of always getting into good position when leaving the house is 
one easily acquired. As in everything else,^ it is the repeated 
doing that leads ultimately to the established usage. 



CHAPTER XIV 

HOW TO CORRECT POOR POSTURE: HOME EXERCISE 

Whenever posture is habitually poor, there are weak muscles 
failing to do the work necessary to hold the body erect. By an 
effort of the will these muscles may be contracted for a brief 
period, as described in the last chapter, so that the position is 
temporarily corrected ; but such momentary activity will not 
be sufficient to permanently improve their tone (strength, elas- 
ticity, and habitual tension) . Such tone can come only through 
their repeated alternate contraction and relaxation in gymnastic 
exercise especially designed to call them into play. This type 
of gymnastic work is known as corrective exercise. These same 
muscles may act, to be sure, in other kinds of exercise, — in 
playing tennis, for instance. In such use, however, because the 
attention is occupied on external matters, their old habit of co- 
ordination with other muscles is continued, with the result that 
those habits are even more firmly fixed and the poor posture 
is confirmed instead of altered. To change these habits of 
coordination, or relative tension between different muscle groups, 
conscious effort must be made to that end, and corrective exercises, 
taken with definite effort, are the only means of achieving the re- 
sult. It is because of its failure to cultivate muscular strength 
that the "nagging" method of correcting posture fails, and 
works the greatest injustice to the child, for it throws upon spas- 
modic nervous 'effort work that only strong muscle fibers can 
sustain. 

132 




Plate XV. — Aristogeton. Noysel Bourbon Museum. 



HOW TO CORRECT POOR POSTURE 135 

In selecting exercises to be done at home for the correction 
of posture, the individual needs of each case should be con- 
sidered. It is desirable in any scheme of exercise to avoid 
monotony, that interest may be kept alive, and with it greater 
energy for the movements. This may be done by occasionally 
adding or substituting new elements, but in this place the subject 
cannot be gone into in such progressive detail ; a few exercises, 
however, that have been found needed by, and effective for, 
many thousands of children, are described. For nervous or 
delicate children of elementary school age, who are having sys- 
tematic corrective exercise in school, the first three exercises may 
be found enough for daily use at home, if their faults of posture 
are those indicated. % 

As a preliminary to any exercise, the correct standing position 
should be taken, and it should be held throughout. At the close 
of each exercise (or before the full number of counts be finished, 
if there be signs of fatigue), the good standing position should 
be relaxed for a few moments to relieve any tiresome muscular 
tension, and then resumed before going on with the movements. 
Too much stress cannot be laid upon this assumption of the 
correct position as a preliminary. Without it, corrective exercises 
do not correct, but only aggravate every fault of posture ; with 
it, they not only give the right direction and pull to particular 
muscles, but associate different groups in the right proportion, 
so that exact muscle tension and habits for maintaining the 
correct position are established. 

Assuming, then, that the body is placed in correct posture 
to start with, and that this is maintained throughout except for 
intentional intervals of relaxation, the following exercises will 
be found useful for strengthening the muscles that are weak 
in faulty position of the parts indicated : — 



136 



THE POSTURE OF SCHOOL CHILDREN 



I. FOR CORRECTING THE POSITION OF THE SHOUL- 
DER 'BLADES. — Swing the arms forward to shoulder level 
and bend the elbows so as to bring the finger tips to the top of 
the shoulders, with the elbows pointing forward (Fig. 49). This 
is the starting position, and the fingers remain on the shoulders 
throughout this particular exercise. From this position, lift 
the elbows and describe with them a semicircle at the sides, 
upward, backward, and downward (Fig. 50). This closing 

position should leave the 
upper arms close at the 
sides and should contract 
the muscles that draw the 
shoulder blades close to- 
gether ; that is, inward to- 
ward the spine and flat upon 
the back. 

Take the movement de- 
liberately, then swing the 
elbows directly to the front 
again, the finger tips remain- 
ing on the shoulders, and repeat the upward, backward, and 
downward motion of the elbows, describing with them a semi- 
circle in one continuous movement. 

A tendency to thrust the head forward as the shoulder blades 
draw together, as well as a tendency to let the upper part of the 
trunk sink backward, will have to be firmly resisted (Fig. 51). 
To avoid these faults of execution, keep the upper part of the 
trunk well forward, with the chest over the toes, and the chin 
drawn inward. The opposite fault of hollowing the back too 
much and thrusting the ribs and sternum too far forward will 
also have to be avoided. The objects of the exercise are (i) 




Fig. 49 . 



Starting position for the shoulder 
blade exercise. 



HOW TO CORRECT POOR POSTURE 



137 



to strengthen the muscles that hold the shoulder blades in posi- 
tion, and (2) to isolate the action of these muscles from others 
of the trunk, — a control that is usually accomplished with 
comparative facility through this exercise. 




Fig. so.- — Terminal position of the shoul- Fig. 51. 
der blade exercise. Correct attitude. 



- Incorrect terminal position for 
shoulder blade exercise. 



A weak child could do this exercise three or four times in 
succession without resting, and may soon work up to ten times 
in succession, though one should always remember to relax 
the good standing position for a moment when it seems partic- 
ularly difficult to hold, or is seen to be wavering. 



138 



THE POSTURE OF SCHOOL CHILDREN 



The use of braces for round shoulders is only justifiable in 
extreme cases — mostly, if not wholly, of the resistant type — 
and after other measures have failed. In this phase of develop- 
ment, as in all others where the fault is one of weak muscles, the 
main remedy must lie in strengthening these and in removing 
all hygienic causes or persistent conditions that aggravate the 
trouble. In the chapter on the shoulders was explained the 
difference between resistant forward shoulders, in which some 





Figs. 52-53. — Head exercise for correcting a forward droop of the neck. {These, and 
succeeding illustrations in this chapter from Bancrofts ''School Gymnastics, Free Hand,'' 
by courtesy of Messrs. D. C. Heath b" Co.) 

structural peculiarity prevents correction in the usual ways, 
and round shoulders that may be corrected by exercise and 
hygiene. Resistant cases are apparently very rare. 

2. FOR CORRECTING THE POSITION OF THE HEAD. — 
In many exercises the head and neck are treated as one, for 
many movements that affect one, affect the other. The fault 
most frequently found with the carriage of both is the forward 
slope of the neck — a drooping forward that is accompanied 
inevitably by a protrusion of the head and often by a thrusting 
forward of the chin. The remedy lies in strengthening muscles 



HOW TO CORRECT POOR POSTURE 



139 



on the back of the neck and shoulders that hold the cervical 
region of the spine erect. These muscles may, in the following 
exercise, be made to work strongly against the resistance of other 
muscles on the front and sides of the neck, which, in turn, lift 
the chest. 

Still holding the correct standing position as a foundation, 
and placing the hands on the hips, with thumbs backward and 



t\ 





Correct Incorrect 

Figs. 54-55. — Exercise for the position of the back. 

elbows pointing straight to the sides, relax the head and drop it 
backward. This is the preliminary movement and is one of 
relaxation, having no effort in it. From this position lift the 
head upward and draw the chin strongly inward, as though 
making a double chin (Figs. 52-53). The effect is to straighten 
the forward slope of the neck, as with a checkrein, so that its 
column is upright instead of inclining forward. Relax the mus- 
cles again, letting the head drop backward, and repeat the strong 
upward pull. This exercise, like its predecessor, should be re- 
peated from four to ten times in succession. 



I40 



THE POSTURE OF SCHOOL CHILDREN 



3. FOR CORRECTING THE POSITION OF THE SPINE. 

— Of the many exercises that affect the spine in various ways, 
the following is one of the simplest to be understood, and very 
effective for correcting exaggerated antero-posterior curves, and 
for strengthening the erector muscles on the back. 

Placing the hands on the hips as described for the previous 
exercise, and holding the head firmly in a good position, bend 

the trunk forward 
from the hips, — 
not from the waist 

(Figs. 54-55)- The 
bend should be 
only so far as may 
be done without 
throwing the head 
out of position, or 
bowing over the 
back. This will be 
rather slight with 
most subjects, es- 
pecially at first, 
and it should be 
understood that the benefit of the exercise is not dependent 
altogether on the degree of the bend, but on its effect on 
the curves of the spine. It corrects an exaggerated lumbar 
curve, and the upper back muscles are strengthened through 
resistance to the pull of gravitation as the trunk bends forward. 
From this forward position rise to the erect attitude once more, 
and repeat the bending forward. 

When this exercise can be repeated ten times in succession 
without relaxing the position of the head or upper back, the work 




Fig. 56. — Starting position for arm movement to be com- 
bined with trunk exercise. Correct position. 



1 



HOW TO CORRECT POOR POSTURE 



141 



of these upper muscles may be increased by adding an arm 
exercise. For this, instead of placing the hands on the hips, 
place the arms in the position shown in Fig. 56. While holding 
them there, bend the trunk forward as before, with the chin 
drawn inward. Without the support of the hands on the hips, 
the tendency to bow the back over will be quite strong, but the 
perfect alignment of the 
trunk should be main- 
tained while the arms are 
stretched sidewise, with 
the palms downward, and 
then again bent to the 
position of Fig. 56. This 
arm movement may be 
repeated four times with- 
out lifting the trunk, 
which should then be 
brought to the upright 
position, with the arms 
hanging at the sides. 
After a moment's rest, 
repeat the whole exercise. 

Eventually this exercise should be done from four to ten times 
in succession, the forward bend being held each time long enough 
to stretch the arms sidewise four times. 

4. FOR THE LOWER BACK AND WAIST (ABDOMINAL) 
MUSCLES. — A sidewise bending of the trunk is good not only 
for certain muscles connected with the lumbar region of the 
spine, but has so stimulating an effect upon the circulation of 
the liver and other abdominal organs that it is one of the stand- 
ard movements for improving digestion, and may well be in- 




FiG. 57. — Incorrect position for starting the arm 
movement which is combined with the trunk ex- 
ercise. 



142 



THE POSTURE OF SCHOOL CHILDREN 



eluded for its dual value. The hands should be placed on the 
hips, the head and upper part of the trunk should be held firmly 
in correct relation to each other, and the trunk then bent directly 
sidewise at the waist line (Fig. 58). There should be no 
twisting of the shoulders, and the feet should be kept firmly on 
the floor. Return to the upright position. Bend the trunk in 

this way as far as possible, from 
four to ten times to each side, 
pausing for an instant each time 
in the upright position as a dis- 
tinct finish to the movement and 
to make sure that the posture is 
correct. 

5. FOR THE ABDOMINAL 
MUSCLES. — Sit on a stool, or 
sidewise on a chair, in front of 
some piece of furniture under which 
the toes may be firmly caught to 
act as a brace and give a purchase. 
With the trunk and head perfectly 
erect, and the hands on the hips, drop 
the trunk backward from the hips to 
a slanting position (see Fig. 90). The degree of the bend will 
depend upon the strength of the abdominal muscles which keep 
the body from falling backward during the exercise, and which 
also pull it up into the erect position at the close. The last 
movement forms the second and most important part of the 
exercise. A trembling of the trunk, or a need for great effort 
in returning to the erect position, indicate that the backward 
movement has been too far. People with very strong abdominal 
muscles can drop backward until the trunk is horizontal ; but 




Fig. 58.- 



Trunk bending to the 
side. 



HOW TO CORRECT POOR POSTURE 



43 



when that can be done, the exercise may better be taken sitting 
on the floor, still with the toes caught under some firm support, 
and the hands on the hips. From this position, sink slowly 
backward to a recumbent attitude — that is, lying flat on the 
back ; from this raise the trunk again to a sitting position. At 
first, in rising from the recumbent position, there may be some 
slight help from the elbows placed against the floor, but this 
should soon be done away with, so that the work will be entirely 
by the abdominal muscles. 

Whether this exercise be taken sitting on a chair or on the 
floor, a firm alignment of the head and spine should he maintained 
throughout. A forward yielding of the head, or caving in of the 
chest, makes the exercise one of the worst aggrq/uations of poor pos- 
ture imaginable, while correctly done it is one of the best of correc- 
tives (see Figs. 90 and 91). The backward movement should 
be entirely from the hip joint, and never from the lumbar region 
of the spine (hollow of the back). 

This backward bending exercise should never be taken from 
a standing position, as it then becomes one of the most harmful 
movements for posture, as may be seen in the atrocious at- 
tit-ide of the first figure in illustration No. 11. Correctly taken, 
tliis movement is one of the exercises that combin^es strong physio- 
logical with postural effects, its influence upon the circulation 
and functioning of the abdominal organs being of the best. 
Repeat from two to ten times. 

6. FOR BALANCE OF THE WHOLE BODY. —A deep 
bending of the knees, with the body sustained on the toes, is 
one of the best of balance exercises. Like all exercises of this 
class, if correctly done, it equahzes the tension of the muscles 
on the front and back of the body, estabUshing a just coordina- 
tion between them, so that they are more apt to hold the body 



144 



THE POSTURE OF SCHOOL CHILDREN 



in perfect equilibrium at other times. Of course this effect is 
lost if there be any yielding from the perfectly upright positions 
of the trunk throughout the performance of the exercise. 

With the hands placed on the hips, rise on the toes, and, 
keeping the heels from the floor, bend the knees to an acute 
angle, or as far down as may be without tipping the trunk for- 
ward (Fig. 59). From this, rise to the erect position, not re- 
turning the heels to the floor until the 
knees have been stretched to their 
utmost. Repeat the exercise from four 
to twenty times. 

The effect of this exercise on the 
circulation is fully as great as its in- 
fluence on posture, and it is classed as 
one of the best of hygienic exercises. 

7. BREATHING EXERCISE.— No 
table of exercises may be called com- 
plete that does not contain breath- 
ing exercises, both for their postural 
and physiological effects. While forced 
respiration does not of itself do all 
that is necessary to insure ^correct development or posture of 
the chest, it does much to restore a collapsed chest to a 
more nearly normal position, and to rouse the respiratory 
muscles to freer and fuller action during normal respiration. 
The stimulus of cold, fresh air, directly from out of doors, 
is most desirable for all exercises, and especially for re- 
spiratory exercises. Stand before an open window, with 
the hands on the hips to relieve the chest of any weight 
from the arms, and draw in slowly as full and deep a breath as 
possible ; slowly exhale ; repeat from four to ten times. Should 




Fig. 5g. — Knee bending for 
balance. 



HOW TO CORRECT POOR POSTURE 145 

there be any dizziness, pause for a few normal breaths between 
the forced respirations. This breathing should be entirely 
through the nostrils. 

This forced breathing may well be taken after every other 
exercise in the preceding list. 

Summary. — This table of exercises may be tabulated for 
convenience as follows : — 

1. Elbows forward and backward. 

2. Head bending backward. ^ 

3. Trunk bending forward. Later, add to this, arm stretching 
side wise. 

4. Trunk bending sidewise. 

5. Sitting, trunk dropping backward. % 

6. Knee bending. 

7. Breathing exercise. 

It hardly need be pointed out that this table contains pretty 
thorough all-over exercise, effective for both postural and phys- 
iological purposes. It is excellent for adults as well as for 
children. Because of the general invigoration resulting, it 
will do much good in cases of lateral curvature of the spine if 
none of the prohibiting conditions be present that are mentioned 
in the chapter on that subject. It is not, however, especially 
adapted to scoliosis, and is far from being an adequate series for 
the treatment of that condition. It may be well again to say 
that all such cases should have the care of a specialist. 

FOR FAULTY FOOT POSITIONS. — The need for a special- 
ist's care applies also to faulty foot positions, but for cases where 
a tendency to too much toeing out or toeing in has not yet 
developed into structural difficulty with the arch of the foot, 
there may profitably be added to the foregoing table one or two 
foot exercises. For too much toeing out, (i) sit, and turn the 



146 THE POSTURE OF SCHOOL CHILDREN 

foot (toes) inward against resistance of some fixed object, or the 
hand of some one assisting. (2) Stand, turn the toes inward, 
and rise on them repeatedly. (3) Walk across the floor several 
times on the toes while they are turned inward. For toeing in, 
these same exercises may be taken with the toes turned outward. 
In either case, especial care should be taken in all normal activi- 
ties to sit and walk with the toes directed straight forward.^ 

Some orthopedists allow a very slight turning out of the toes 
to be normal in adults,^ though the weight of modern opinion 
is in favor of the straight foot position. That the straight foot is 
natural for children may be observed by any one who will notice 
the feet of a class of children not conscious of being observed for 
this point. Their toeing out when they know the feet to be 
under inspection shows at once that it is a position artificial and 
cultivated. The best direction to give children for a simple stand- 
ing position is '' Feet together," and not " Heels together." 
Nature will take care of the rest, except in cases of weak arches 
and muscles that need special care. Later, a turning out of the 
toes may be a necessary part of the technique in certain gym- 
nastic positions, as in the knee bending described for home 
exercise, and in some dancing. The position is found, however, 
to be less necessary in dancing of other than the advanced classic 
type than was formerly supposed.^ Running, dancing, and rope 
jumping are among the best exercises to strengthen the feet if 
not kept up for periods of fatiguing length. 

FOR CULTIVATING CORRECT CHEST PROPORTIONS. 
— The broad, correctly proportioned chest, may best be culti- 
vated by those exercises, whether as formal gymnastics or in the 
form of sport, that extend the upper arm vigorously outward or 
upward from the shoulder joint. The tendency of the arm move- 

^ McKenzie, 98; Taylor, 132. 2 Qchsner, 106; Rotch, 118. ^ Taylor, 132. 



HOW TO CORRECT POOR POSTURE 147 

ments in exercises i and 3 is in this direction, and large swing- 
ing movements with Indian clubs, in which the arms are stretched 
sidewise to their full extent, are even more vigorously calculated 
to cultivate breadth of chest. Swimming, rowing, and tennis 
are particularly adapted to aid such development, as the for- 
ward throwing movement of the arm, which is not good for pos- 
ture either of chest or shoulders, is made with less force in these 
sports than in games where the ball is thrown from the hand. 
If tennis be played ambidextrously, the symmetry of its training 
is, of course, enhanced. Dr. Woods-Hutchinson favors also 
for such development of the chest the climbing and swinging 
exercises of the gymnasium in which the weight of the body is 
suspended from the upward stretched arms, as in overhead 
ladder, ring, bar, and stall-bar work. A clear distinction should 
be made between the effects of these exercises and of those in 
which the weight is pushed up from below, as on parallel bars. 
The sort of " traveling " (on ladders, etc.) that stretches the 
arms sidewise as well as upward, is especially broadening in its 
effect on the chest. 

Even if the chest index show a normal development, there 
can be no doubt of the wisdom of having throughout the growing 
years a considerable amount of these wide, swinging, and stretch- 
ing movements of the arms, whether in formal gymnastics at 
home or school, or in heavier gymnasium practice or sport. 
And always it should be appreciated that vigorous functioning 
of the heart and lungs, induced by active exercise of the leg and 
trunk muscles, especially when these lead to '' breathlessness," 
has a profound effect on the right development of those organs 
and of the bony cage which contains them. 

FOR THE GENERAL CONSTITUTION. — Finally, general 
vigor and tone of the system are reflected in posture, and for 



148 THE POSTURE OF SCHOOL CHILDREN 

this reason, especially, exercise should by no means be confined 
to the specialized corrective type. The constitution should be 
reenforced with vigorous out-of-door activities in which there 
is no thought whatever of posture. The life of every boy and 
girl should contain an abundance of those sports and games for 
which, when the motor system develops normally, there is an 
instinctive liking just at the time when heart and lungs, and all 
the great metabolic processes, are needing vigorous stimuli. 
Swimming, rowing, skating, tramping, climbing, baseball, tennis, 
indeed, all active games, — especially the team ball games, — 
athletic sports, horseback riding (cross saddle for girls), dancing 
(if not accompanied by late hours and other unhygienic con- 
ditions that nullify its benefits) , — some of these activities belong 
to any comprehensive and adequate scheme of physical train- 
ing, because of their effects on the general constitution as well 
as for their other educational values. None of them, however, 
can take the place of definite, corrective, formal gymnastics for 
the training of posture. Only such a type of work can over- 
come faults of posture and train erect carriage. The effect on 
posture of most other types of exercise is indirect, and one might 
be a devotee of any or all of these activities and still have very 
poor carriage of the body. This fact is illustrated at almost 
every athletic meet or tournament. The direct service of these 
varied types of recreative exercise lies in a different direction 
from, though one equally necessary with, the correction of 
posture ; and just as these activities supplement and comple- 
ment corrective exercise in the upbuilding of the body, so in 
turn must they be reenforced with selected gymnastic work of 
the corrective type for harmonious development of physique. 



CHAPTER XV 

HOME HYGIENE FOR POSTURE: LEARNING TO STAND AND 
WALK; NUTRITION; SLEEP AND SLEEPING POSITIONS; 
CHAIRS AND TABLES; WEIGHT CARRYING; MUSIC PRAC- 
TICE 

Any one charged with the physical development of large 
numbers of children, or even of one child, must realize the 
molding influence of those constant conditions that we call 
hygiene. Again and again weak phases in physique, Hke weak 
phases in mental work, are traceable directly to loss of power due 
to poor nutrition, late hours, overdoing wifh duties in the home 
or outside of it, or any one of numerous other influences that 
only those who control home conditions may remedy. In trying 
to correct posture, there is added to this Kst of adverse influences 
many that bear even more directly on the correct development 
and carriage of the body. For example, what chance is there 
of making permanent gain in the correction of posture, when 
the clothing worn by a child is so shaped that it continually 
pulls the figure out of true? The shape and size of chairs at 
home have as much effect upon the posture as they have in the 
much-discussed realm of school furniture. All of the physical 
conditions for home study and reading, piano or violin practice, 
even sleeping postures, are among the constant influences that 
are molding the body for good or ill during these susceptible 
years of growth. 

LEARNING TO STAND AND WALK. — Whether a child's 
first efforts to assume the erect position in standing and walk- 
ing be prompted by instinct or conscious effort, has been a 

151 



152 THE POSTURE OF SCHOOL CHILDREN 

subject of considerable discussion among psychologists. As 
in most such discussions, the probabilities seem to be that 
both elements are so blended it is difficult to separate them. 
Whatever the impelling power may be, a normal child learns 
these things through such repeated efforts and failures, and such 
a long apprenticeship, that it is no wonder so weak a power shows 
lack of fixed control throughout the years of growth. 

The head is the first part of his body which the child, unaided, 
holds erect; this power he acquires sometime between the 
second and fourth months; sitting independently is an accom- 
plishment that comes from the seventh to the tenth month; 
the proud moment of standing alone comes about the eleventh 
or twelfth month, and is followed by walking somewhere between 
the twelfth and fifteenth months. Some infants omit the in- 
termediate stage of creeping, and some, probably discouraged 
by the fright or hurt of an unusually severe fall, may revert for 
a period to creeping after learning to walk.^ 

In their efforts at standing and walking, most children, es- 
pecially if very heavy in weight, need moderate restraint rather 
than encouragement. Long periods of standing or walking 
should be avoided. This caution applies to children well up to 
eleven or twelve years of age, though a robust child of ten should, 
if habituated to it through shorter walks, be able to walk two 
or three miles. 

These precautions are to avoid overstrain and fatigue on all 
the muscles and ligaments that maintain erect posture, from 
the feet to the head. The ill effects of excessive standing or 
walking extend even to the bones, which are very pliable at this 
age, owing to the small proportion of mineral matter in their 
composition. 

1 Holt, 66; Rotch, ii8; Cotton, 24; Trettien, 138. 



HOME HYGIENE FOR POSTURE 153 

The way in which an infant is carried may also have a per- 
manent effect upon its posture and the correct development of 
chest and spine. Orthopedic surgeons consider that lateral 
curvature of the spine may be caused by the habitual carrying 
of a child over one arm. There is a great difference between 
allowing a child to sit in the crotch of the arm and letting it 
hang, face downward, over the arm. The latter position tends 
to crush in the chest on one side, and twist or rotate the pelvis 
and spine sidewise. 

NUTRITION. — It is a mistake to think that all underfed or 
poorly nourished children come from homes of poverty. One 
often finds, on the contrary, that of the large numbers of children 
who rush to school in the morning with only a cup of stimu- 
latmg coffee or tea, or whose midday meal is made up mainly of 
unwholesome pastries, the greater number come from homes of 
economic comfort or even affluence. The question of dietary 
per se is not germane to the present study ; yet one can but point 
out that good nutrition is fundamental to the growth, and to 
the nervous and muscular. power that are at the base of proper 
development and posture. In the chapter on school hygiene 
one instance is related where a marked gain in posture for a 
whole class followed so simple a matter as the drinking of a cup 
of milk in the middle of the forenoon — a gain from marked 
defects that seemed impossible of correction under previous con- 
ditions. When one adds to this physical gain an improvement 
in mental condition that increased by one or two hours the 
power of close attention, one appreciates somewhat the im- 
mediate influence of nourishing food. An underfed child, or one 
suffering in any way from poor nutrition, cannot be expected 
to stand erect, or to develop a good chest or other proper pro- 
portions or carriage of body. 



154 THE POSTURE OF SCHOOL CHILDREN 

SLEEP AND SLEEPING POSITIONS. —The large numbers 
of children who are up late on city streets help to explain the 
large percentage of so-called " backward children" in the schools. 
Nothing more quickly reduces nerve force or the efficient work- 
ing of the entire organism than loss of sleep, — a fact to which 
many an adult afflicted with insomnia can testify. The revival 
of the curfew bell in many village and even city communities 
is a wholesome regulation physically as well as morally; and 
where parents have not enough control to regulate the retiring 
hours observed by their children, such help from community 
authorities might well be extended. Many children who retire 
at proper hours are found to suffer from sleeplessness, much of 
it apparently related to the number of hours of work done 
through the day, and also to the proportionate amount of this 
done in the afternoon and evening, — matters that bear directly 
on home study. The normal hours for sleep at different ages 
have been given as twelve hours at seven years of age, eleven 
and a half or twelve hours at ten years, eleven hours at fourteen, 
and eight and a half to nine hours from eighteen to twenty years 
of age.^ 

Like nutrition, sleep is fundamental to proper growth and 
development ; but both nutrition and sleep have a constitu- 
tional, and not a specialized, relation to posture. The positions 
habitually assumed in sleep, however, have a very direct and 
important bearing on postural development. Sleeping positions 
have come to be recognized as a feature in scoliosis, an habitual 
lying on one side allowing a sag in the spine, between the hip 
and shoulder, which form the points of support. Reversing the 
position helps to correct such a curve, by reversing the direction 
of the sag, as shown in Fig. 60. Dr. Fitz is quoted as follows : — 

' Hall, 55. 



HOME HYGIENE FOR POSTURE 



155 



''The period of sleep is one half to one third the growing time of 
the child, and, consequently, the pressures and strain of an habitual 
sleeping posture have an opportunity to influence the growth of the 
vertebrae and ligaments and shape them in accordance with their 
relative positions at such times." ^ 







A.wt i'i i lj -iA 




Fig. 60. — An S-shaped lateral curve of the spine and the effect of sleeping positions 

upon it. {Courtesy of Dr. Fitz.) 

If this be true of lateral curves, it applies equally to the antero- 
posterior curves of the spine. Lying on the back on a very high 
pillow must obviously thrust the neck forward, while lying on 
the side with or without a pillow would increase any tendency 
to the forward position of the shoulder blades. 

This does not mean that one should not lie on the back or on 
the side, or never use a pillow. It means that just as the habitual 
sleeping posture of a case of lateral curvature must be studied 
to ascertain a possible contributing cause, so must each case of 
postural defects of other t}'pes be observed for the particular 
habit that may be increasing or even causing the difficulty. 

1 Fitz, 39. 



156 THE POSTURE OF SCHOOL CHILDREN 

All authorities agree that for children of all ages the sleeping 
position should be changed frequently. There can be little doubt 
that there is a great tendency to use pillows that are too high, 
and that many people of noticeably fine carriage sleep much 
on the back and even without any pillow. Marie de Manaciene 
found that, among boys and girls, about forty per cent of the 
sleeping time was spent upon the back naturally, and also noted 
an instinctive tendency to lie prone on the face or stomach. The 
latter position she recommends for both children and adults for 
a half hour before rising, because of the influence in relieving 
pressures on the circulation.^ 

All of this only confirms the general principle that for the 
correct development of posture, sleeping positions, like those for 
standing and sitting, should be much varied, that the condi- 
tions (in this case, high pillows) should be right, and that in- 
dividual faults of posture should be studied, that those habitual 
sleeping positions which aggravate or cultivate them may be 
avoided. 

CHAIRS AND TABLES. — One has only to watch in the 
street cars the posture of little children sitting on seats so high 
that their feet cannot reach the floor, to realize how the custom 
of expecting children to adapt themselves to the chairs of grown- 
ups, both at home and outside it, must affect the posture of all 
but the most robust. The whole body seems to yield with col- 
lapsed chest and shoulders in the direction of the suspended feet, 
and there are probably few adults who have not a vivid mem- 
ory of aching backs that, in their childhood days, accompanied 
dangling legs in church, parlor, or at the dining table. 

The harm wrought by misfit furniture on the posture of school 
children has long been recognized. Specialists in the medical 

1 Manaciene, 94; Osborne, 109. 



HOME HYGIENE FOR POSTURE 159 

profession and in education and invention have combined, and 
commissions have been appointed, to devise furniture correct 
in shape and adjustable to the varying heights of growing bodies. 
Yet how much attention does this subject have in the average 
home? Probably the children are exceptional who, after they 
outgrow the " high chair " of infancy, are not expected to eat 
at a high table, seated on a chair that necessitates the craning 
of necks and the dangling of feet. 

The harm of these positions is explained, with illustrations, 
in the chapter on school hygiene. In this place it may be stated 
that both for adults and children, the shape as well as the height 
of chairs is of especial importance for proper development and 
carriage of the body. Many chairs literacy mold the sitter 
into most harmful positions. A forward vertical curve in the 
chair back will thrust the head forward if at the top, or make 
inevitable a sliding forward and downward in the seat if at the 
bottom. A lateral curve around the shoulders makes improb- 
able a correct carriage of the shoulder blades for one who sits 
much in such a chair. The rounded shape thrusts the scapula 
forward, and if used habitually becomes a potent cause of round 
shoulders. A straight lateral line is unquestionably best for a 
chair back ; also a backward slope that leaves the adjustment of 
curves to the sitter, while affording a plane surface against which 
to recline. In special chairs for use by students, typists, or pian- 
ists, it is possible to secure adjustable devices that place back 
supports at different heights for different sitters ; but the or- 
dinary house chair is probably best in the simple lines just de- 
scribed. 

In Plate XVII is shown an ideal nursery, in which the little 
occupants have for their meals table and -chairs that are changed 
in height for them as they grow. The Httle schoolgirl has the 



i6o 



THE POSTURE OF SCHOOL CHILDREN 



same consideration in desk and chair for her home study, and 
note should be made of the low shelves for toys and books, which 
aid orderliness as well as posture. 

Home furniture, easily adjusted as children grow, is as much 
needed as easily adjusted school furniture. While all homes may 




Fig. 6i. — Poor conditions for home study or reading. 

not afford special furniture for the children, it is possible for every 
home to contrive, if only with boxes, the proper support for the 
feet, and the right height of the chair seat in relation to the 
height of tables. 

So long as five hours of school work are not considered enough 
in one day for growing children, and one or two hours more must 
be added at home, the conditions for home study should be as 



HOME HYGIENE FOR POSTURE 



i6i 



free from injury as possible. These conditions include, aside 
from the height of furniture, some propping of books, so that 
the head need not be bowed over a level surface for reading and 
writing (Fig. 6i). The dual effect of such a stooping position 
on eyesight and posture would seem too obvious to need dis- 
cussion ; but any one 
who tries to correct 
either defect in chil- 
dren finds, in a large 
majority of cases, seri- 
ous neglect of the home 
conditions mentioned. 

WEIGHT CARRY- 
ING.- — The carrying 
of heavy loads is fatal 
to good posture in a 
child. Indeed, even 
with adults, so in- 
grained do the effects 
of this become, that 
characteristic posture, 
permanently fixed in 
bones and muscles, is 
an accompaniment of 
many occupations. 
Witness for this the high 

shoulder of the postman who does not shift his load ; a similar un- 
evenness in the bookkeeper who stands or sits habitually with one 
side turned toward his desk ; or the forward and sidewise yielding 
of the figure of the mother or nurse who carries in the arms 
much of the time a heavy child. It is this carrying of little 




Photograph by Brown Bros. 

Fig. 62. — The distortion of posture that comes from 
carrying httle brothers and sisters. 



M 



l62 



THE POSTURE OF SCHOOL CHILDREN 



brothers and sisters (Fig. 62) that, of all the forms of burden 
bearing, oftenest distorts the posture of older children, though 
the ranks of child labor are full of pitiful examples of httle 

shoulders over- 
weighted (Fig. 
63). If children 
could all be 
trained to carry 
weighty burdens 
on the head, 
whenever prac- 
ticable, like the 
httle ice bearer 
in Fig. 38, we 
would probably 
be a better and 
stronger race in 
many ways, with 
posture as excel- 
lent as his. It 
is not impossible 
that such a 
method of carry- 
ing school books, 
at least within the 

school buildings, may be found feasible, and if so, it would 
remove one of the most harmful features of school hfe. 

The carrying of loads of books, and methods for relief, are dis- 
cussed with the school hygiene of posture. It may weh be 
pointed out in this place, however, that where children have such 
loads to carry, the plan of the school for reducing these should 




Photograph hy Broum Bros. 



pjg 63. — Stunted growth and poor posture result from the 
burdens of child labor. 



HOME HYGIENE FOR POSTURE 163 

be understood at home and all possible cooperation given from 
there. Sometimes such a school plan includes the taking home 
and returning of part of the load at noon and part at the close 
of the afternoon session, instead of all at one time. A bit of 
watchfulness at home would help in this. The plan suggested 
by a wise school principal of carrying the books on different 
sides different days ; or — a suggestion of another principal — 
of dividing the load between the two arms, might well have home 
assistance for its enforcement. Where circumstances admit of 
dupUcating the books, or at least the larger and heavier ones, 
so that one set may be kept permanently at home, the best solu- 
tion of the question will undoubtedly have been found, until 
such time as all school work shall be done in school. 

MUSIC PRACTICE. — Every pupil in piano and viohn 
playing is taught most carefully the correct posture of wrist 
and fingers, but how many instructors ever say a word about 
the posture of the rest of the body ? And yet this is a matter of 
fundamental importance to the musician as to others, consider- 
ing its relation to general health. Not only would the fatigue 
of practice be lessened by such instruction, but permanent in- 
jury, telling on efficiency in all other activities, might be avoided 
by care for general habits of posture. 

In Fig. 64 is shown the position induced by sitting at a piano 
without support for the feet — something required of almost 
every child whose piano instruction begins at an early age. 
The rounded back, collapsed chest, forward shoulders, and pro- 
truding head are as surely induced through sitting in this way at 
a piano, as at the dining table or in school or church. Plate 
XVI shows the feet supported by a little footstool, and the re- 
lief is apparent throughout the entire tlgure. 

Violin practice is a fertile cause of lateral curvature of the 



164 



THE POSTURE OF SCHOOL CHILDREN 



spine, and while the attitude that leads to it may not be wholly 
done away with in playing that instrument, every lesson or period 
of practice should be followed, or even interrupted, by exer- 
cises that bend the trunk and head in the opposite direction, 
or strengthen on both sides the muscles that are concerned in 




Fig. 64. — Incorrect position at the piano without support for the feet. 

symmetrical posture. The table of exercises already given is 
suitable for this, with especial emphasis on number four when 
bending to the right side, adding to the trunk movement a 
vertical stretching of the left arm, to be maintained during 
the bending. 




Richter 



Plate XVIII. — Queen Louise. 



CHAPTER XVI 
THE HYGIENE OF POSTURE: DRESS 

When Louis XIV asked the opinion of his French tailor on a 
costume imported from England, the Frenchman looked him 
over with unconcealed contempt for the foreign rival, and said, 
'' You are covered, sire, but you are not clothed." 

Presumably dress is for the purpose of covering the body, 
but when art is added to utility, the strong^oints and beauties 
of the structure covered are emphasized, just as an architect 
adds strength to beauty in the design for a building by conform- 
ing to, and emphasizing, its structural features. The main 
difficulty with (so-called) civilized dress, from the hygienic 
standpoint, is that it is not content to take the human structure 
as it exists, but must mold it over into grotesque distortions. 
In this sense, most of us are usually ''covered, but not clothed." 
So much is said of the effects of corsets and high heels for women, 
that the chief ills of clothing seem concentrated in these features, 
and the fact overlooked that the clothing of men and boys often 
has equally harmful features. Only one who is trying to correct 
the posture of boys in large numbers may, perhaps, fully appre- 
ciate how distorting are certain features of their clothing. 

Most harmful, perhaps, is the making of coats so high in the 
neck behind that they He like the yoke of a harness across the 
cervical spine, thrusting the head forward. With this position 
of the head is usually found the depressed chest and forward 
position of the shoulders. The shoulder position is still further 

167 



1 68 THE POSTURE OF SCHOOL CHILDREN 

aggravated by shoulder seams in the coats, set so that they 
Hterally mold and hold the shoulder blades in a forward 
position. This means that practically the entire weight of the 
coat, instead of being balanced so that it helps to maintain a per- 
fect equilibrium of the body when in the upright position, drags 
downward and forward. When to the weight of the suit coat 
is added that of an outer or over coat, it is not surprising that a 
slouching habit of carriage is characteristic of so many boys, 
even of those having strong muscular development. 

This cut of coat is by no means exceptional. Ask a boy in such 
a suit to assume a perfectly erect posture, and the amount of 
push necessary against the collar behind will show in the upward 
lift of the coat in front, and a pouching out of the collar at the 
sides over the chest. Unbuttoning the coat is necessary to give 
room for the lifted chest, but so long as the neck and shoulders 
of the garment are cut wrong, the weight will drag the body 
forward and downward. A corrected position of the shoulder 
blades in such a coat shows in a wrinkle of the garment be- 
tween the shoulders behind, indicating at once the exaggerated 
roundness which it both cultivates and is cut to cover. 

These same faulty lines are found in shirts and shirt waists, 
where the shoulder seams are often badly misplaced and 
the collar band set so high behind that the linen collar rests 
upon it with the opening directed too much forward instead of 
upward. The neck in such a collar is held in a forward position 
as though in a vise, or as pilloried in the stocks of colonial days, 
and any training for correct posture in such clothing is help- 
lessly wasted. 

Another feature of boys' clothing that drags the figure out of 
place is suspenders. These have the same effect as the ill-cut 
coat. Nearly all suspenders seem to cut in at the hollow of 



THE HYGIENE OF POSTURE 169 

the shoulders in front, emphasizing the forward thrust of the 
tips of the shoulders, with the consequent protrusion of the 
scapulae behind in wing shoulder blades, and dragging down- 
ward of the clavicle and ribs (chest) in front. A surprising 
number of small boys in the intermediate grades are found 
dragged downward with suspenders. In one school, situated in 
a "mixed" neighborhood as to economic conditions, in five 
classes from the fourth to the sixth year inclusive, out of two 
hundred and thirteen boys, one hundred and thirteen, or fifty- 
three per cent, were found wearing suspenders. 

When to these faults of boys' clothing are added the stiffness 
and weight of paddings and interlinings, overweighting the 
front of the coat and designed to hide the^very contortions of 
figure which they cultivate, it is not surprising that erect pos- 
ture is one of the very uncertain features of growth. 

All that has been said of the cut of garments for boys so that 
they hang as a harness yoke on the neck and shoulders, thrust- 
ing these forward and dragging the chest downward, applies 
as well to much of the clothing of girls. The lines of neck, collar, 
and shoulder seams in gowns are often as vise-like in their hold 
as when they occur in the heavier materials and stiff linen used 
for boys' clothing. For little boys and girls, underwaists and 
straps that suspend the weight of clothing from the shoulders, 
have usually quite the same effect as suspenders. Orthopedic 
surgeons find these to be among the contributing causes of 
lateral curvature of the spine, ^ and the physical trainer knows 
that they are among the basic causes of antero-posterior faults 
of posture. 

As a remedy for all these misfit garments, a demand from the 
pubUc for clothing that will fit the properly erect figure would 

1 Goldthwait, 54 ; Lovett, 86, 



lyo THE POSTURE OF SCHOOL CHILDREN 

doubtless lead to different models from manufacturers, who are 
ever eager to meet a general demand. 

In girls' clothing it is unnecessary to say that corsets and 
corset waists have an immediate influence on posture. The prob- 
lem of corsets is by no means confined to the older girls of high 
school and college or to adults. In the elementary schools a 
large percentage of girls wear corsets in the last two years of 
the grades, — girls from thirteen to fifteen years of age. In 
some sections corsets are found to be worn even earlier. A new 
school of medical opinion has recently appeared in relation to 
corsets. Finding that for reasons of comfort, neatness, and 
elegance of effect in gowning, many women, especially those 
inclined at all to stoutness, will not give up corsets, Drs. Reynolds 
and Lovett of Boston and Dr. Dickinson of Brooklyn have made 
a study of the garment and its effects, with a view to determin- 
ing the most and least harmful features, in order that they may 
" prescribe where they cannot proscribe." These studies in- 
clude the effect of corsets in throwing the body out of good 
posture, effects caused by different shapes or cuts of the gar- 
ment. The pressures exerted at different points by such shapes, 
and the harm produced by them, have also been investigated.^ 

The tightness of a corset, or the old fault of " lacing," is only 
one feature of its deleterious influence ; its shape may work 
harm on a woman who never laces at all, and this may be as great 
from a soft " waist " as from a stiff corset. For corsets and 
waists, as for other ready-made clothing, the public gives too 
meekly-compliant a submission to tradition, and acceptance of 
whatever is commercially available, and an insufficient under- 
standing of what constitutes beauty of figure. Young girls, 

^Dickinson, 31; Reynolds and Lovett, 115; Mosher, 102; Galbraith, 44 
below; Kellogg, 77, 79, 80. 



THE HYGIENE OF POSTURE 



171 



especially, need to be set right as to what are the proper curves 
and outlines of the figure. Probably the girls are rare who do 
not think that a mature figure means one that slopes inward at 
the waist in front, and that to do away with this slope means 
to give up all tapering lines for the waist. A normal waist does 
curve inward at the sides in the 
space between the ribs and the top 
of the hips (pelvis or crest of the 
ilium — the bony structure that may 
be felt by pressing inward at the 
sides just below the waist line). This 
inward curve is apparent at the sides 
when looked at from the front, and 
continues all around the back, where 
the " hollow," if not exaggerated, 
forms one of the most beautiful lines 
of the figure ; hut it does not con- 
tinue directly across the waist line or 
"pit of the stomach" in front. Pres- 
sure at that point in front is re- 
sponsible for some of the worst 
displacement and crowding of organs, 
for much indigestion and malnutri- 
tion, and for some of the worst faults of posture. The ap- 
pearance of an inward slope of the waist in front is caused by 
the maturing of the figure above the waist ^ the bust — and 
not by an actual inward slope of the waist itself. This fact 
every girl should understand clearly. 

To appreciate these contours of the figure, one should remember 
that below the chest (ribs), the front of the trunk is made up 
entirely of soft muscles that yield easily to compression, having 




Fig. 65. — The rectus abdominus 
muscle which should determine 
the outline of the front of the 
body. {Adapted from Meyer.) 



172 



THE POSTURE OF SCHOOL CHILDREN 



no bony structure underneath to resist this. There is one long, 
straight muscle in particular that gives the outline to the front 
of the body and that is very important in posture. This is 
the rectus abdominus, attached above to the lower edge of the 
ribs and sternum, and below to the front of the pelvis, as shown 

in Fig. 65. When this muscle is com- 
pressed, it may be seen at once that the 
effect is to pull the chest down from 
above and tilt the front rim of the pelvis 
upward from below so that the natural 
hollow of the back is obKterated, and the 
upper part of the trunk bows over, as 
shown in Fig. 66. The stomach, intes- 
tines, and other organs are necessarily 
crowded out of place, and indigestion, 
constipation, headaches, backaches, and 
many ills that come from congestion and 
sluggish circulation are the inevitable 
consequence. 

The so-called "straight front" corset 
has wrought a great improvement in this 
Fig. 66. — Figure distorted one particular fault of corsct making, but 

by compression at the front 

of the waist. {Courtesy of most corsets are Still cut SO that they 

Dr. Dickinson.) 

crowd the figure too much inward im- 
mediately on each side of the central Hne in front. For 
the width of the rectus abdominus muscle, and somewhat 
beyond it, the corset should be straight in front, curving out- 
ward above the waist to meet the bust ; the inward taper should 
begin around toward the sides and extend from there entirely 
across the back. This inward curve of the waist in front is not 
the only harmful feature of ill-shaped corsets. There has arisen 




THE HYGIENE OF POSTURE 173 

an idea that because a straight hne is good on the front of a 
corset it is equally desirable behind, and as a result the " straight- 
back " corset has come into existence. This is one of the most 
deforming corsets ever devised, and is responsible for a mode in 
posture that is ridiculous in the weak and fairly idiotic contours 
that it cultivates. By forcing the buttocks inward, this corset 
tilts downward the posterior rim of the 
pelvis, obliterates the lumbar curve, and 
forces a collapsed position of the chest, 
and a forward thrust of the head. 

The physicians quoted agree on the 
general points of corset shape, and also 
that the way in which a corset is laced 
and put on are as important as its cut. 
The greatest pressure should be below the 
line of the hips (i.e. below the crest of the 
ihum). At that point it may be very 
snug, as pressure there sends the organs 
upward and holds them in place, instead 
of dragging them downward. This pres- 
sure from below upward is a needed cor- 

FiG. 67. — Correct lines for 

rective in many cases for sagging stomach, corsetted figure. {Adapted 

from Dickinson.) 

intestines, and other viscera. 

The authorities quoted also agree that the corset may fit the 
figure above the hip crests at the sides and back, hollowing in 
closely to the lumbar curve. It should not, however, exert 
such a pressure against the shoulders as to tilt the trunk forward 
beyond the perpendicular, for, even with the support of a corset, 
this throws a severe strain upon the overstretched muscles and 
ligaments of the back that keep the body from falhng forward.^ 

1 See Appendix, Note 8. 




174 THE POSTURE OF SCHOOL CHILDREN 

It should be clearly understood that sanction for the wearing 
of corsets applies to the adult, and not to the immature figure. 
One cannot make too emphatic the harm that results through 
crushed ribs, restricted growth, displacement of organs, and in- 
terference with all of the great physiological functions, from 
constriction during the period of growth. This emphasis be- 
comes especially necessary in view of the fact that it is not un- 
common to find girls in the elementary schools so bound by corsets 
that one could no more alter in them the curves of the spine, or 
the position of the chest, than a piece of wood could be bent. 
Drs. Williams and Fothergill attribute much of the chronic 
anaemia in young girls through the late teens to interference 
with the liver through tight dressing.^ 

Of these anaemic girls, Dr. Fothergill says, '' They adopt 
corsets when they are still thin and undeveloped, and never 
allow the waist to develop." He recognizes that corsets trans- 
mit the pressure of skirt bands to the hips and ribs, which is a 
desirable thing, and protect from the pressure of such bands 
the organs in the region of the waist. As long as skirt bands 
are fastened around the waist, he believes that corsets should be 
worn, but they should be stiff, straight front, cut on the right 
lines, and large enough. 

Only in an exceptional case of mature figure has any girl in 
the elementary schools an excuse for wearing corsets. The 
main reasons most women would give for wearing them are to 
keep the form (gown) neat as the figure grows heavier, and to 
avoid the discomfort of bands at the waist. The slender sup- 
pleness — or, if larger, the muscular firmness — of almost all 
girls of school age render useless a garment which at the best 
tends to limit proper developrnent during the growing years, 

1 Williams, 144 ; Fothergill, 43. 



THE HYGIENE OF POSTURE 175 

and which at all times interferes with the free movements that 
alone can lead to the best condition of the muscles and organs 
of the trunk. The weight and constriction of skirt bands may 
be as harmful as, and far more uncomfortable than, corsets, and 
provision for union garments, or other means of suspending the 
weight of clothing should be used when corsets are not worn. 
An abdominal girdle which does not extend above the ribs, and 
from which the direction of pressure is upward from below the 
waist, is much worn by singers, who must have free action of 
ribs and diaphragm. 

The dress of the feet has a great deal to do with the carriage 
or posture of the rest of the body, as well as of the feet themselves, 
and with ease and grace of movement in walking.^ 

When a very young child first bears his weight upon his feet, 
the foot muscles and ligaments are very lacking in strength, and 
have to gain this by use. By six years of age the adult type of 
foot is practically attained.^ 

The custom of making shoes for very little children on a 
straight model, so that there is no right nor left, is a great mis- 
take, for the two feet are not shaped alike at this age any more 
than later, and the arch needs support especially at this time 
when it is first gaining strength to hold the weight.^ 

The shape of socks and stockings is quite as important as that 
of the shoes, the wearing of socks too short or inflexible having 
the same effect on the foot as a shoe of similar faults. The nat- 
ural use of the foot in sandals or shoes that give play to the 
muscles is an especially important element in these early years. 
Unless he discloses through in-toeing or out-toeing some 

^ Taylor, 132, 133 ; Woods-Hutchinson, 72 ; Reynolds and Lovett, 115 ; Rotch, 
118; Cook, 23 ; Holt, 66; Jaeger, 74; Pyle, 112; Galbraith, 44. 
2 Rotch, 118. 
^Whitman, 143; Ochsner, 106; Rotch, 118. 



176 



THE POSTURE OF SCHOOL CHILDREN 




weakness of the foot muscles and ligaments, a child will be found 
to use naturally the straight-foot position, with the toes point- 
ing forward. The avoidance of too prolonged standing or 

walking at one time are also important. Dr. 
Rotch says : " Children should not be taught 
to turn the toes out . . ., as this puts the 
arch in a position where the muscles give it 
least support. The average dancing-school 
master is a fair example of what ... re- 
spected traditions of the past can do to 
children's feet." 

" Toeing out " may be a necessary part 
of the technique of some 
dancing and gymnastic 

Fig. 68. — Normal out- 
lines of adult feet positions, but this is prov- 

(W hitman). . . , . 

mg to be much less neces- 
sary than was formerly thought, and some 
modern dancing teachers are modifying their 
requirements for toeing out. 

Very high-heeled shoes, or those that 
through narrowness or pointed shape cramp 
the toes so that they cannot spread naturally 
when the weight is thrust upon them, make 
the foot more a hoof than a foot, so that it 
becomes a stiff, inflexible pedestal attached 
to the leg. 

Figure 68 shows the normal outline of 
adult feet, and Fig. 69 the abnormal crook of the great toe 
that comes from wearing pointed- toed shoes. When such a 
deformity has been established, a pointed-toe shoe, if very 
long, may be comfortable, but it never gives the proper 




Fig. 69. — Abnormal 
shape of feet culti- 
vated by narrow- 
toed shoes {Whit- 
man). 



THE HYGIENE OF POSTURE 



177 



play to the foot, as any one who has tried the comfort of 
so-called orthopedic shoes can testify. Above all, pointed 
toes and high heels should never be used for prolonged walk- 
ing or standing. Weakened arches, bunions, and an abnor- 
mal strain on the ligaments that maintain the erect position 
are the inevitable result of high-heeled, pointed-toed shoes. 

The greatest difficulty at present in extending the use of prop- 
erly shaped shoes for women and older girls lies, undoubtedly, 
in their lack of aesthetic values. When such shoes can be made 
to appear dainty and beautiful, women will not hesitate to wear 
them. Meanwhile, many women of would-be common sense com- 
promise by using orthopedic shoes for ordinary walking or long 
tramps, and shoes shaped differently for dress occasions. The 
author knows one woman of remarkable vigor for sixty years of 
age, known for the elegance of her dressing, who wears moccasins 
for long daily walks in the country. 



N 



CHAPTER XVII 
EFFICIENCY METHODS FOR SCHOOL TRAINING 

The efficiency methods here explained constitute a new and 
systematic way of getting and estimating results from the usual 
procedures for correcting the posture of school children. They 
possess a tremendous psychological power, shown in the interest, 
enthusiasm, and definite effort and zeal roused both among 
teachers and pupils, and have led to really remarkable results. 

The essential principle of these efficiency methods is that 
this phase of physical development — erect posture — has been 
standardized so that each individual is judged, not merely for 
temporary ability to assume a good position, but for endurance 
in holding it. By means of this standardized test, the class 
teacher, who is not a trained specialist, may easily judge the 
posture of her own pupils, and also, through a percentage esti- 
mate, determine from month to month her success in develop- 
ing her class as a whole. 

By " standardized " is meant the adoption of definite criteria 
by which the subject may be judged. The term is adopted 
from the work of the new school of efficiency engineers, and ex- 
perts in scientific management, who, in the field of industry, 
are quietly working a wonderful revolution by which waste is 
eliminated at a saving of millions of dollars annually, the out- 
put proportionately enlarged, time and labor saved for the 
workman, and his earning power increased. One of the fun- 
damental principles of efficiency engineering is the standardiza- 

178 f 




tiaint-Gaudens 



Plate XIX. — Lincoln. Chicago. 



EFFICIENCY METHODS FOR SCHOOL TRAINING i8i 

tion of every element involved, from the actual physical labor 
of the workman to the cost of materials, — the adoption, in 
other words, of a unit of measurement whereby each step in the 
operation may be judged. In the realm of physical activity, 
this standardization has been applied to a wide range, from 
the coarsest movements of unskilled labor to the finest adjust- 
ments of hand and eye. The most famous illustration of the 
results of these methods is found in the improvement worked 
out in brick laying, whereby the brick facing on a great sky- 
scraper building in New York was done in days instead of the 
months that such a task usually takes. Another illustration 
is an increase in the output of cards containing typewritten 
data. A room full of girls, through a simple device for bringing 
the copy nearer to the work, increased thek output from twelve 
hundred to three thousand cards per day. 

This standardizing of industrial operations is done through 
a study of the movements of the worker, the quality and appro- 
priateness of his materials and tools, and all conditions under 
which he works. Nothing is too small to escape notice, not even 
a movement that requires but a fraction of a second to perform. 
Nothing is more conspicuous in these efficiency methods than 
their humanitarian concern for the worker. One of the most 
important phases of the subject is the study of fatigue, the con- 
ditions that contribute to or lessen it, and the point at which 
it is reached. For instance, the girls in a factory were watched 
to see when they, showed signs of nervousness and fatigue, with 
the result that they were given a ten minutes' recess at the end 
of every hour in which to get up and move around. Their work- 
ing day was shortened by two hours, and yet, through the 
greater efficiency of methods, material, and conditions, there 
was a material increase in their wages, and in the output of the 



1 82 THE POSTURE OF SCHOOL CHILDREN 

shop. How long will it be before we look the facts of the school- 
room as squarely in the face and adapt methods to them instead 
of to tradition? The instance cited in another chapter of the 
physical and mental improvement wrought in a class of children 
by a daily cup of milk and fifteen minutes of quiet rest is elo- 
quent of the waste through child, teacher, and school plant that 
might be saved by applying to school problems the methods of 
the efhciency engineer. 

In physical activities the efficiency engineers have developed 
methods of motion study, and of proportioning hours of rest and 
work to the weight of loads carried and the resistance overcome, 
that are apparently achieving more immediate and practical re- 
sults than years of laboratory work over the chemical products 
of fatigue and kindred abstruse problems, however important 
and necessary those may be. The results with over two hundred 
thousand children that have come from applying some of these 
principles to the development of posture is one indication of what 
may come from such work, and there are many other phases of 
education, both physical and mental, to which they will some 
day undoubtedly be appHed. 

The first element in the standardization of posture is the 
adoption of an effective criterion by which the teacher may 
know if pupils are standing correctly. This was found in the 
vertical line test; whereby the entire figure is judged by one 
glance of the eye, and details left for after-adjustment. The 
posture itself is that for which practically all physical trainers 
and orthopedists work, but the author became convinced that 
the traditional methods of securing it were not sufficiently 
effective, or they would lead to a better recognition of the subject 
on the part of class teachers. Such methods seemed, on critical 
scrutiny, to be too detailed and analytic, and really not so much 



EFFICIENCY METHODS FOR SCHOOL TRAINING 183 

what the speciahst uses, as an analysis or explanation of what 
he uses. The trained specialist knows at a glance whether or 
not a figure is erect ; he does not build up that knowledge by 
looking separately at head, hips, shoulders, etc. 

The vertical line test, then, is the first element in this stand- 
ardization of posture, and the child is first judged by this means 
in a simple standing position. It is, however, a fact of common 
observation that a child who can assume a good position for a 
few minutes may not hold it ; posture fluctuates. Some test 
of his endurance in holding the position was obviously necessary, 
so to judgment of his simple standing position was added two 
other means of judging his power for erect carriage, making in 
all a triple test. This is based on the question, What is a rea- 
sonable standard to expect the school to* produce? Certainly 
its children should be able, not only to stand correctly, but 
to maintain this position in marching in and out of assemblies, 
or to the yard and back for recesses and dismissals. Marching 
was therefore added to the requirement, especially when it 
proved on closer study to be one of the surest means by which 
the body returns to its faulty habits of carriage, if the muscular 
tone and coordination for good posture be not well estabhshed. 
Such tone can only be cultivated through corrective exercise, 
taken with the body held in good position. Obviously it would 
be foolish to consider that a child had an acceptable standard 
of posture if he could not take his gymnastic exercise in a way that 
would insure his proper development. Therefore the mainte- 
nance of good posture during exercise was added, making alto- 
gether a triple test which has proved a thoroughly reasonable, 
and very effective, standard to which every child in a school, 
barring extreme pathological cases, should be able to conform. 

This triple test for posture is, then, the standardization of the 



i84 



THE POSTURE OF SCHOOL CHILDREN 



subject for the individuaL It is explained more fully in a 
succeeding chapter. Every child who passes this test is entitled 
to a passing mark on posture, even though he may sometimes 
fluctuate in his carriage ; and those children who are habitually 
in good posture for standing or sitting should have more than a 
passing mark, being given the highest credit for the subject. 




Fig. 70. — The molding influence of the elementary school. 

The difference between marking children for posture according 
to this test, or by other methods, should be clearly appreciated. 
The two other methods most commonly used are (i) to give a 
general estimate based on a general observation, more or less 
expert ; or (2) to give a numerical credit for different details, as 
five points for good carriage of the head, five for the shoulders, 
etc. The author is convinced that the general judgment of 
the posture of a class^ even by the expert, is neither adequate nor 



EFFICIENCY METHODS FOR SCHOOL TRAINING 185 

accurate. For example, after witnessing a demonstration of 
the triple test with a class of children, one keen observer — a 
physical training specialist — said of the group of children who 
had failed on the test, but who had been put in good position and 
were marching out of the room in it, '' And you call those chil- 
dren poor in posture ! Until a half hour ago I should have called 
them excellent in posture." Posture is one of the points on 
which children are marked for graduation from the New York 
City elementary schools, but until these efficiency methods were 
introduced, there were as many standards for posture as there 
were observers. The general judgment, therefore, even of the 
expert judging the class as a whole, is not as reliable as this 
test. One is an actual counting of facts — the scientific method ; 
the other a general impression — the empirical method. The 
values of the two cannot be compared, for they belong to en- 
tirely different types of procedure. The author has always 
used statistical methods of estimating conditions and progress 
in school work, but has never found any method that was appli- 
cable to the results of teaching physcial training that were so 
exact a reflection of the facets as these efficiency methods. 

The marking of posture by numerical credits for different 
details scarcely needs discussion after a reading of preceding 
chapters. The action and interaction of different parts of the 
body are such, and they are all so blended in every attitude, 
that even the scientists who have spent years of special study on 
the problem cannot satisfactorily classify the various combina- 
tions of these types of posture. How, then, may one give three 
credits for the head and four for the chest ? Have the shoulders 
a greater valuation than the feet ? One is in good posture, or he 
is not ; he holds it habitually, or at least through a reasonable 
test, or he fails so to do. These are the essential facts, and the 



i86 THE POSTURE OF SCHOOL CHILDREN 

value of details lies in the teacher's ability to recognize and cor- 
rect them, and not in a numerical equation. 

Before leaving the subject of credits it should be pointed out 
that one feature of great moment in these efficiency methods — 
a feature that, so far as the author knows, marks a new and 
very important departure in physical training — is that the 
pupil is credited for his physical condition or development, and 
not alone for the amount of time he devotes to the subject, nor 
even for his performance in a lesson. When this principle of 
credit for actual physical condition can be extended to other 
phases of development than posture, physical education will 
mean, by just that much more, something greater than the 
practice of exercises. Our schools and colleges should give their 
full or highest diploma only to pupils of sound physical condi- 
tion ; and throughout the school or college course this condition 
should be a distinct subject of credit, entirely apart from any 
means taken to achieve it, such as the hours devoted to gym- 
nasium or athletic practice. These means, on the other hand, 
should have separate credit of their own, and the pupil who 
needs rest, or special diet, or any other means of physical up- 
building, should, if these things be prescribed for him by the 
physical director, be credited with them as much as with 
gymnasium practice or any other aids to condition or devel- 
opment. 

This principle is applicable to both physical and mental 
development. When we can measure both the physical and 
mental powers in more definite and practicable ways, we may 
be able to distinguish between three separate and distinct lines 
of credit, viz. (i) the physical and mental powers or condition 
of the individual, (2) the mere number of hours he devotes to a 
subject, and (3) the amount of knowledge which he possesses. 



EFFICIENCY METHODS FOR SCHOOL TRAINING 187 

The efficiency methods for posture proceed from the stand- 
ardization for the individual, to the standardization for the 
class. To what extent is the teacher succeeding in her work 
in this subject? Heretofore she has had her own or an expert 
judgment as to whether it was good, bad, or indifferent. But 
there has been no definite point to reach — no means of knowing 
if she were gaining, or to what extent her efforts were telling in 
actual improvement in her pupils. One of the most important 
features in these efficiency methods has been the furnishing of 
a means of answering these questions. On the basis of the 
triple test, made once a month, the class is segregated into two 
groups for posture, one which passes the test and one which does 
not. The number in the good posture division, divided by the 
number present when the test is made, shov^ the actual percent- 
age of pupils that passes a reasonable test on this subject. If 
only twenty per cent can pass the test, the teacher knows that 
she has some vigorous work to do on the posture of the group 
that fails. No teacher, no class, will rest content on a twenty 
per cent achievement. Right here lies the crux of the great 
psychological power inherent in these methods, a power that 
was a complete surprise to the author as they were worked out, 
and that proved to be a keynote in their success. The children 
will work for promotion from one posture division to the other, 
and also strive to raise their class average, with a zeal that they 
have never before shown in any phase of physical training ex- 
cept, perhaps, in the winning of trophies in athletics. 

This interest and enthusiasm of the children show that these 
new methods have supplied a motive previously lacking in their 
work for posture. True, their pride and ambition have pre- 
viously been appealed to, but the interest so roused has not 
hitherto been sustained. Prizes, banners, trophies, posture 



i88 THE POSTURE OF SCHOOL CHILDREN 

pins, and honorable mention have each had their trial with simi- 
lar results. These last-mentioned appeals are now classed with 
auxiliary aids ; in pedagogical language they are incentives 
as distinguished from motives. The efficiency methods have 
supplied motivation to the pupils' work for posture.^ 

The quality of corrective teaching on the part of the teachers 
has similarly been imbued with new life and raised to a higher 
standard. Many a teacher has transferred her emphasis 
from the material of physical training (exercise) to the child. 
Instead of asking, " Is this exercise or dance step right ? " '' Will 
you give us a new game? " the specialist has been sought with 
the questions, " What is the matter with this boy? " " What 
can I do for this girl? " " Won't you just look at the improve- 
ment in this little fellow? " " This child has worked so hard 
and improved so much, do you think he might be promoted to 
Division I? " With such a point of view it is much easier for 
a teacher to see why her shoulder-blade exercises are not pro- 
ducing results, or how to improve the posture in some other 
exercise with correct execution of form instead of harming posture 
with incorrect execution. Best of all, back of this improved 
teaching is a spirit of personal sympathy and concern for the 
welfare of pupils that far transcends any pride or ambition for 
class ratings. The individual test leads to a recognition of the 
personal needs of each pupil as no other methods known to the 
author have done, and nothing in a long experience has shown 
so impressively the great spirit of devotion to the welfare of pupils 
that underlies the teaching profession. 

Group teaching is another feature of these efficiency methods 
that has helped much in raising the standard of teaching gym- 
nastics. Reward to the child through promotion from one pos- 

^ See Appendix, Note 9. 



EFFICIENCY METHODS FOR SCHOOL TRAINING 189 

ture group to the other is another very effective element. This 
is a direct adaptation of the principle of frequent reward that 
is a feature of efficiency engineering. Another of these efficiency 
principles that is of primary importance is the keeping of syste- 
matic records. For the posture methods these records are 
simple — three figures a month for each teacher to write as a 
result of her triple test. There is no burden attached to them ; 
and yet too much cannot be said of their influence and help for 
pupils, teachers, and supervisory officers. 

The results of these efficiency methods may be stated in 
figures as follows: During the first term of extensive use of these 
methods they were tried in nearly one thousand classes of the 
seventh and eighth school years, including 32,967 children. 
In February of that term only forty per cent of these children 
could even stand correctly ; ^ in June, eighty- three per cent of them 
could pass the triple test for endurance of posture in standing, 
marching, and gymnastic exercise. In the next school year 
the methods were" extended to about five thousand classes and 
upward of 200,000 children from the second to the eighth school 
year inclusive, with commensurate results. There are but few 
children in those classes who cannot assume good posture, and 
the large majority can hold it through the triple test. The 
result is cumulative, and each term finds more children able to 
pass the test, and more who, through the establishment of cor- 
rect habits and a gain in muscular strength, are rated '' A " for 
habitually good posture. 

^The preliminary working out of these methods in a few schools and classes was 
inspired by a marked decline from a formerly high standard of posture — a decline 
that had resulted from the introduction of numerous influences that proved to 
be detrimental to it. 



tgo THE POSTURE OF SCHOOL CHILDREN 

In making up statistics of these results it has seemed best to 
confine them to the number of classes that could be personally 
examined by a small corps of eight specialists, in order that 
variation through the personal equation might be as slight as 
possible. The judgment of this group of workers was as nearly 
uniform as frequent work with a central authority could make 
it. They made all of the tests in the first term's work, and in 
succeeding terms examined personally the graduating classes 
in seventy-seven elementary schools, which included nearly 
four thousand children. During the first term, while the classes 
of the seventh and eighth years combined achieved an average 
of eighty-five per cent, the graduating (8B) classes reached only 
seventy-four per cent. During the second term in which these 
methods were used, the graduating classes rose to eighty-five 
per cent, and in the third term to ninety per cent. During the 
first summer vacation the posture efficiency dropped twenty- 
four per cent. That is, while eighty per cent of the children 
in a few classes and schools selected for this phase of the 
study could pass the triple test in June, only fifty-six per cent 
could pass the test in September, showing the effects of ten 
weeks without the special training. During the second summer 
vacation these same classes dropped only ten per cent as com- 
pared with twenty-four per cent the previous summer. That 
is, ninety per cent of these children passed the triple test in 
June, and eighty per cent in September. These facts show 
the cumulative effects of the work. A change from fluctuat- 
ing to habitually good posture (ratings of B or C changed to 
A) is plainly apparent by actual count in schools doing the best 
work in the subject, and in those schools the good posture of 
the children is not lost even in the excitement of team games, in 
which their attention is thoroughly engrossed in the play. 



EFFICIENCY METHODS FOR SCHOOL TRAINING 191 

An outline of the administrative plan by which these methods 
were generally introduced may be of service. For the first term 
the corps of specialists concentrated their attention wholly on 
this phase of physical training (posture tests and corrective ex- 
ercise)/ although without their aid the classes kept up folk danc- 
ing, games, and other recreative forms of work. Each class was 
tested by the specialist personally with the class teacher present, 
the latter then being given special help on the corrective phases 
of her gymnastic lesson.^ Individual, class, and supervisor's or 
school records were started personally by the specialists, aided by 
many excellent suggestions from the school force. A very impor- 
tant feature of this campaign was a series of lectures on posture to 
the class teachers, illustrated by stereopticon pictures. Through 
these illustrations the eye was trained toMiscern the points of 
correct carriage. Many teachers attended these lectures volun- 
tarily three times in succession, as they found the need for further 
discrimination or understanding of the subject. Many teachers' 
meetings were also held in individual schools, at which classes 
were put through the triple test and corrective exercises demon- 
strated. 

In all of this work, children are never brought forward for 
individual criticism of posture in a way that makes them conspic- 

^ The latter was the regular course of study that has been used in these schools 
for many years. The exercises in this course are over ninety per cent corrective, 
although many of them possess dual and triple values, as explained in the chapter 
on Home Exercise, giving the work also a high percentage of hygienic and other 
values. 

- Later, when the methods were extended to a larger field, one class was put 
through the triple test by the special supervisor, while a group of class teachers 
observed and then segregated each her own class in readiness for the inspection 
and possible correction of the specialist. This group work with the teachers was 
merely to enable a very small number of experts to cover a very large field, and 
not by any means because it was considered superior to the individual class help. 



192 THE POSTURE OF SCHOOL CHILDREN 

uous before the class. How to avoid this has been a special study, 
but that each child is one of a group has, in itself, almost elimi- 
nated all personal feeling. In criticizing posture in individuals, 
the positive, constructive tone has been adopted where it seemed 
necessary, especially when the methods were new. For example, 
the comment has often been, not, " This boy's shoulders are 
wrong," but, " This boy needs to work longer for strong shoulder- 
blade muscles." In a matter of this kind there can be no abso- 
lute rule, and individual tact must be ever in play. The diffi- 
culty of personal criticism proves, however, to be much less 
than might be anticipated, because of the group idea just cited, 
and also because the children come very quickly to regard the 
whole subject as they would any other in the school program 
in which their individual rating of good or poor is part of the 
day's work. 

The efficiency of school training for physical development will 
never be what it should until much more than posture is stand- 
ardized. Among the features that are greatly in need of such 
service are (i) other bodily functions or phases of develop- 
ment, (2) the amount of time needed for different types of 
exercise in order to produce their results, and (3) the amount 
of expert assistance needed by class teachers to produce results. 
The work with the efficiency methods here described has helped 
towards tandardization of (2) and (3), but has not completely 
solved the questions. It has been thoroughly demonstrated that 
for the cultivation of correct posture in children of elementary 
school age, and probably in those of higher grade as well, daily 
work with corrective exercises is absolutely necessary. The 
amount of time needed for this corrective exercise may vary 
with the introduction of new movements and the amount of in- 
dividual help required by the pupils ; but it should never be less 



EFFICIENCY METHODS FOR SCHOOL TRAINING 193 

than fifteen minutes per day, though not necessarily in one 
period. For many children, especially those having pathological 
defects, special classes under the instruction of trained experts 
should be formed. 

The amount of expert help in physical training is far from 
adequate in any public school system of which the writer knows. 
The function of such experts must probably always remain one 
of supervision and assistance, as the number required for teach- 
ing the children personally is usually prohibitive. The number 
of specialists that should be furnished to a school system should 
eventually be a matter of accurate estimate, based on definite 
knowledge of the number of classes in which may be obtained a 
fair average of results in the various lines of development. At 
present the number of specialists is determified by arbitrary con- 
ditions in which such a knowledge of the facts apparently plays 
no part. This condition is undoubtedly very largely due to 
physical trainers themselves. When they can demonstrate results 
in measurable terms, as is here done for posture, there will be an 
accurate basis for determining the number of specialists needed. 
Meanwhile, the multiplicity of physical activities grouped under 
the head of physical training, to say nothing of school hygiene, 
makes it plainly evident that every school of forty classes or over 
should have at least one expert to direct and assist with its gym- 
nastics, folk dancing, games, athletics, and other t3^es of 
exercise. 

When the organization of an industrial plant on principles 
of efficiency, or scientific management, is first attempted, the 
management, it is stated, is almost invariably inclined to con- 
sider impossible the cost of the corps of experts required. Only 
experience convinces them that an expenditure in this way of 
ten or twelve thousand dollars or more per year will save a much 



194 THE POSTURE OF SCHOOL CHILDREN 

larger amount by checking waste of all kinds — waste in effort, 
material, etc. — and by increasing the output through greater 
efficiency. It is, perhaps, not too much to predict that when 
physical trainers can demonstrate with equal certainty the 
results of their work, the outlay for salaries that will command 
adequate service will not be begrudged. 




Vandyke 



Plate XX. — Prince Ruprecht. 



CHAPTER XVIII 
THE TRIPLE TEST AND GROUPING FOR POSTURE 

With an understanding of the vertical line method of judging 
good posture, each teacher should once a month put her class 
through a triple test which indicates the endurance of the pupils 
in holding a good position. 

On the basis of this test the class should be divided into two 
groups — Division I, composed of those who pass the test, and 
Division II, those who do not pass. Both divisions should 
take their gymnastic lesson at the same time, but stand in two 
distinct groups, which enables the teacher to concentrate atten- 
tion on the division most needing help for corrective effects from 
the exercises. This grouping also incites the pupils in Division 
II to work for promotion to Division I. 

The triple test consists in judging each child's posture in 
(i) standing, (2) prolonged marching (four or five minutes), 
and (3) selected exercises. A child may be able to assume good 
posture for a few moments, but lose it when he returns to habit- 
ual activities or when his attention is diverted to other things. 
For this reason, to judge of posture in the standing position alone 
is not adequate, and the triple test has been found eminently 
fair and satisfactory. No child who has habitually good posture 
could fail in this test, and any child who is equal to it certainly 
deserves a passing mark on the subject. 

THE TRIPLE TEST is conducted as follows: — 

(i) STANDING TEST. — Pupils should be looked over\ in 
profile. Those who do not stand in correct posture should be 

197 



iqS 



THE POSTURE OF SCHOOL CHILDREN 



eliminated, — that is, asked to sit down or to move to one side. 
In a classroom this review of the standing position may be made 
by having the entire class stand at once, or else row by row, the 
teacher looking them over from the side of the room ; or, if 
she be in front, by having the pupils face to the side. Those 




Fig. 71. — Poor posture. 



Fig. 72. — The corrected position (leaning 
forward very slightly too much). 



who stand poorly should be asked to sit ; those who stand well 
should move forward and form a single file across the front of 
the room ready for the marching test. In judging, it is quicker 
and more systematic to dispose of one row or aisle at a time, as 
just described, than to designate pupils promiscuously. 



THE TRIPLE TEST AND GROUPING FOR POSTURE 199 

In a gymnasium or on other free floor space, one may often 
get the best perspective for this standing test by ranging the 
pupils in single file around the outer edge of the room. 

(2) MARCHING TEST. — The pupils selected for their 
good standing position should then be put through an endurance 
test in marching for four or five minutes. An effort should be 
made during the march to distract their attention from any 
artificial effort for posture by drilling on tactics, such as facings, 
marking time, halting, etc. It will be found that as the march 
proceeds, old muscle habits will reassert themselves, and many 
pupils who could hold a correct position for a few minutes of quiet 
standing will fall into habitually faulty attitudes as they march. 
Heads will droop, chest sink, and shoulder joints slip forward. 
As these faults occur, the pupils showing thftm should be dropped 
out of the line. 

(3) EXERCISE TEST. — The pupils who pass the standing 
and marching tests should then be put through the third part 
of the triple test, which is designed to show the strength and co- 
ordination of those muscles that are weak in poor posture, par- 
ticularly those that hold the spine erect. In certain exercises, 
especially those that put the arms in an upward position, the 
posterior muscles, if weak, allow the body to react with poor 
positions, the head drooping forward and the upper part of the 
trunk sinking backward ; or, if the weakness be in the lumbar 
region, an overextension backward may occur, leading to the 
lordosis position (excessive hollow in the back). 

One of the best exercises to test these points is a long sweep 
of the arms forward and upward, fully extended, returning them 
sideways and downward to position at the sides. Any of the 
home exercises noted in a previous chapter would also be good. 
Pupils reacting in these exercises with the faults of execution 
just mentioned should be dropped from the group. 



200 THE POSTURE OF SCHOOL CHILDREN 

This closes the triple test. Pupils who have maintained good 
posture throughout the test (that is, through standings marching, 
and exercise) should be called Division I and thereafter should 
stand apart in one group for the gymnastic lesson. The re- 
mainder of the class should form Division II. These pupils 
should take their gymnastic lesson with Division I, but as they- 
are a distinct group, the teacher may more readily concentrate 
her attention on helping them to correct their posture with the 
exercise. Indeed, this is a fundamental object of the testing and 
grouping, and the methods for improving the posture of Division 
II with exercise will be dwelt upon at length in a succeeding 
chapter. 

The triple test should be given to each class entire once a 
month. A teacher fairly rapid in discriminating posture can 
test a class of forty or fifty pupils in the usual physical training 
period of fifteen or twenty minutes. 

Posture fluctuates in the same individuals. Conditions of 
fatigue, worry, lack of sleep, poor nutrition, or illness of any 
kind may affect it. Some of the pupils, therefore, who pass the 
test for Division I may not always be found in good posture. 
The test therefore selects (i) those who have habitually good 
posture (rated A), and (2) those who are good most of the time, 
but who may fluctuate somewhat (rated B). Instances occur 
where pupils who have been in Division I for a considerable time 
will lapse into poor posture for long periods. Where such lapse 
continues for a number of days, the pupil may well be returned 
to Division II without waiting for the monthly test. In other 
words, it is not kind to a child to allow him to feel that he has 
achieved satisfactory posture when he has not. Teachers should 
guard against rewarding even long efort and marked improvement 
by promotion to Division I, if the child have not actually arrived at 



THE TRIPLE TEST AND GROUPING FOR POSTURE 201 

good posture. Such promotion encourages a child to relax his 
efforts before arriving at the result desired. 

Pupils who have lateral deviations of posture (scoliosis or other 
pathological defects), but who are able to maintain a good posi- 
tion through the triple test, may be allowed to stand with Divi- 
sion I, but should not be rated in posture (A or B), being marked 
instead " medical defect." These pupils should not be counted 
in estimating the percentage of good posture in a class. 

The method by which the two groups take their places for 
the gymnastic lesson is susceptible of many variations, equally 
desirable, the essential requisites of any method being simplicity, 
a minimum of commands, and rapid and quiet changes that 
avoid collisions. Some teachers assign their pupils to perma- 
nent seats according to their divisions in posture, but so many 
other considerations usually enter into seating, that this may 
not always be practicable. The following methods for changing 
places for posture groups have been found to meet all of the 
requirements. 

Pupils who have to pass to the opposite side of the room to 
join their groups do so before the other pupils stand. Assuming 
for illustration that Division I will occupy three aisles on one side 
of the room, the pupils seated along those three aisles who belong 
to the other division (II) are asked to stand, face the rear, and 
march by way of the rear of the room to take any vacant seats 
on the opposite side. At the same time the pupils who belong to 
Division I, but who sit on the opposite side of the room, must 
also change places. They stand, and pass forward to the front 
of the room to cross over to the vacant seats in Division I. 
The pupils in each division having thus filled the seats vacated 
by the pupils of the opposite division, the entire class is asked 
to stand, it being then grouped in two divisions. 



202 THE POSTURE OF SCHOOL CHILDREN 

The change of places is usually made to such commands as, 
" Pupils who change — Stand! " " Pass! " A third order is then 
given to the entire class, " Class — Stand ! " 

In this changing of places for groups or divisions, by having 
pupils for Division I pass to the front of the room and those for 
Division II to the rear, there are no collisions in the aisles. The 
method by which pupils return to their own seats is just the re- 
verse, the commands being: "Pupils near their own seats — 
Sit!" ''The others — Pass!" As before, pupils' returning 
from Division I pass by way of the front of the room, and those 
from Division II by the rear. With very little drill these changes 
are made very quickly, the children usually running to their 
places. As Division I enlarges from month to month by pro- 
motions from Division II, there are fewer pupils to change, and 
the time required is lessened. In a large class where many pupils 
change, from seven to ten seconds is the usual time for this 
grouping, and the same time or less is consumed in returning to 
seats after the gymnastic lesson. 

When the gymnastic lesson is taken in a gymnasium, the group- 
ing may be accomplished as the pupils leave the classroom, 
those for Division I being asked to stand and pass first, and those 
for Division II to follow. They thus pass on to the floor in 
groups already selected. A formation that leaves each group 
extending in files from front to rear, as in the classroom, is 
found better than one that masses either division horizontally 
across the front or rear. 

In both gymnasium and classroom, Division II should stand 
on the side next the windows, that the teacher may have the 
benefit of the light in observing posture. 

PROMOTION FOR POSTURE. — One of the essential 
elements in the success of this group teaching for posture is 



THE TRIPLE TEST AND GROUPING FOR POSTURE 203 

the zest with which pupils work for promotion from Division II 
to Division I. The test alone will not arouse this interest ; the 
grouping must be a distinct, systematic part of each lesson. 
This cannot be too strongly stated. The interest of the pupils 
in promotion is one of the most marked features of these methods, 
and the teacher should rouse pride and ambition to this end. 
Many teachers have voluntarily stated that this element has re- 
lieved them of the necessity for continual '' nagging " about pos- 
ture, and substituted therefor a motive that makes the child 
eager to improve. 

A very potent influence to this same end is class pride for the 
percentages explained in the succeeding chapter. 



CHAPTER XIX 
CLASS STANDARDS; INDIVIDUAL AND CLASS RATINGS; RECORDS 

The triple test standardizes posture so that it is possible to 
rate a pupil on this subject. Every pupil who successfully 
passes the triple test for Division I may be considered as passing 
on this subject, and therefore entitled to at least a passing mark. 
As before stated, the posture of some of these pupils may fluctu- 
ate slightly at times, but will be good in the main. There will be 
others in Division I who have habitually good posture, no matter 
how they may be occupied. The class teacher is the only one 
who can judge of this habitual posture. These pupils should 
have the highest rating for the subject (A). Some teachers 
have preferred to have two sections in Division I, one for A and 
one for B pupils, and this is unquestionably an advantage. Each 
child should keep his individual rating on this subject, and the 
teacher should have the names of the class listed with the posture 
rating opposite each. In discussing ratings farther on in this 
chapter, an admirable form or posture bulletin is shown in 
which the pupils' names are classified in this way according to 
their ratings. 

Habitual sitting positions are, of course, of much importance 
in any rating of pupils for posture. These should be considered 
in giving a pupil the rating of A. Any pupil who can pass the 
triple test for standing posture could pass any test for sitting, 
short of habitual positions. Therefore, it is the A rating that 

should include these. 

204 




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Niehaus 



Plate XXI. — Garfield. Cincinnati. 



CLASS STANDARDS 



207 



CLASS PERCENTAGES. — The triple test not only standard- 
izes posture for the individual, but furnishes a basis for stand- 
ardizing the class as a whole, and this forms a distinct and very 
important element in these efhciency methods. This class 
standardization is arrived at by figuring the percentage of pupils 

in Division I, dividing the number 
who pass the test by the total at- 
tendance — not register — at the 
time the test is made. For in- 
stance, with forty pupils present 
in a class, and but ten passing the 
triple test, the class percentage on 
posture is but twenty-five per cent. 
This does not mean that each pupil 
of those passing is rated at twenty- 
five per cent, but that twenty-five 
per cent of the pupils passed the 
test. It is the class record on the 
subject. Neither pupils, teacher, 
nor principal will rest content with 
so low a figure for this or any other 
subject, and unquestionably an 
enormous amount of the zeal and 
satisfaction which these efiiciency 
methods have aroused, has come from this means of estimating 
class record and progress. It is a great satisfaction to a 
teacher to have a concrete means of estimating the results of 
her work, and there is a strong element of justice involved in 
such a method. 

These percentage figures have roused an interest on the part 
of all concerned that has been most impressive. Many humor- 




FiG. 73. — A teaching problem. 



2o8 



THE POSTURE OF SCHOOL CHILDREN 



ous incidents have shown the interest of the children. The boys 
in one class waylaid a c^ssmate after school and pommeled him be- 
cause his poor posture kept the class from one hundred per cent. 
Another child announced at home with great delight that he had 
been " promoted to Division I in postrophy." 

CLASS RECORD. — The class percentage should be figured 
each month when the triple test is made, and a systematic rec- 
ord kept in each class, both on the blackboard and in some 
permanent form in some record book. This book may well be 
devoted exclusively to the posture record, or part of some other 
permanent record book may be used. A separate book is pref- 
erable, as it gives room for the names of pupils with their in- 
dividual ratings (A, B, or C) in addition to the class schedule. 
A class record for a first term's work might appear as follows : — 



Date of Triple Test 



September lo 
October lo 
November lo 
December lo 
January lo 



Attendance 



46 

47 

48 

47 
45 



Number Pass- 
ing Test 



16 

22 

30 

37 



Percentage in 
Div. I 



34 

46 

62 

68 

82 



When placed on the blackboard, this record rouses the pride and 
interest of the class so that they work to raise the percentage 
from month to month. Another form is a bulletin on which ap- 
pears, in addition to the monthly percentages, the names of 
pupils in Division I, who are classified as A or B. The class 
should always know its percentage, and whether it is gaining or 
losing, or marking time from month to month. To omit this is 
to fail of using one of the most potent psychological elements in the 



CLASS STANDARDS 



209 



r^T Acc T?TrrT>T?'n tm T-'ocxttdtt 


t:»<^t-i 'T'T:'T->-»r T) XT' /-^t-kt-ktt-xt^ 


Class 6 B 






AXIENDANCE 


Number Pass- 
ing Test 


Percentage 
Good Posture 


February 4 . . . . , . . 

March 4 

April 3 

May 

June ........ 


43 

43 
42 


32 

34 
38 


74 

79 
90 


Pupils in Division I for Posture 

A B 

Mary Greene George King 
Isabel Clark Fr^k Munger 
George Mack Margaret Leopold 
Ellen Schneider Ellen Leonard 
Grace King Jefferson Davis 
Fanny Masters Helen Mix 
Rose Ryan Jenny Keagan 
Frank Gray Sarah Lornegan 
George Perkins Ruth Steinheimer 

Giovani Luigi Rebecca Schmitt 

Theodore Rogers 
Luke Regan 
Sylvester Parker 
Mary Alexander 
Thomas Judkins 
Roger Marks 
Lester McCormick 
Mary Thompson 
Katherine Temple 
Kate Gonzales 
Elizabeth Fitzsimons 
Ella Munson 
George Kittridge 
Hans Hansen 
Jans Jacobson 
Mary Peterson 



2IO THE POSTURE OF SCHOOL CHILDREN 

situation, — the one that, coupled with personal desire for pro- 
motion from Division II to Division I, relieves the teacher 
of the necessity for continual nagging about posture, and sub- 
stitutes therefor a motive in the child himself. 

It is not at all unusual when these methods are first introduced 
to find classes that are naught on the first test, — that is, classes 
in which not a single child is able to pass the test. The teacher 
should never hesitate to put down these figures, nor should she 
ever strain a point to promote a child to Division I before he has 
actually achieved the posture that entitles him to be there. In 
other words, it is not figures, but the facts they represent, that 
are essential, and it is unjust to a child to lead him to think 
he has reached a passing mark on this subject when he still needs 
the extra effort and attention for posture that comes from being 
in Division II. Some teachers find it hard not to reward pro- 
longed effort and marked improvement by promotion to Divi- 
sion I before the child has enough endurance in a correct position 
to go through the test. Other means for encouragement for 
such children may be found than allowing them to think they 
have arrived at the desired standard. 

A systematic record of her class percentages may serve the 
further purpose of helping a teacher to find the faults in her own 
judgment or teaching on this subject. For instance, if the per- 
centage be very high, a teacher should make sure that her stand- 
ard is not too lenient. On the other hand, if the percentage 
shows scarcely any advances from month to month, the teacher 
may at once conclude that she is not doing what she should to 
develop the posture of the pupils in Division II, — that she is 
failing in some way to get the corrective values from her gymnas- 
tic lesson, or otherwise missing the points necessary for improve- 
ment. 



CLASS STANDARDS 



211 






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212 THE POSTURE OF SCHOOL CHILDREN 

SUPERVISOR'S RECORD. — A supervisor's record for the 
principal, as here given, is of very great value as showing the 
condition of the various classes in a school at any time, and serves 
also to indicate those teachers who may need help on this subject. 
In the accompanying record, note, for instance, the sudden 
gain in the last month in the 3 B Boys class; the lack of ap- 
preciable gain in the 5 A Girls class ; and the splendid, sustained 
record in the 6 B Girls. The great differences made in per- 
centages by fluctuating attendance is apparent in many cases, 
and for this reason the attendance on the day of the test and 
the number passing the test need to be considered in judging 
the percentage. It is wise to give teachers some leeway in the 
choice of days for making the test, that attendance may be 
good when it is done. For instance, it might be understood 
that the posture test should be made during the first week of 
each month, and the record sheet sent around for the filling in 
of the figures on the last school day of that week. The clerical 
work for such a supervisor's record is very slight, the sheet 
being sent through the classes once a month, that each teacher 
may fill in the three figures resulting from the month's test. 
The sheets in general use are of legal or foolscap size. 

REASONABLE STANDARDS. — Just what is a reasonable 
class percentage on posture? Experience has shown that in 
one year's use of these efiiciency methods eighty-five per cent 
is an average figure, the largest number of classes ranging from 
eighty to eighty-nine per cent, and a considerable number reach- 
ing one hundred per cent, and this, although it is not at all unusual 
for many classes to start at zero. The effect of the work is cumu- 
lative, and each term sees an advance on the ratings of the pre- 
vious term, as the development of the children progresses from 
grade to grade. Were it not for pathological cases, from ninety- 



CLASS STANDARDS 213 

five to one hundred per cent might well be expected of every 
class. In making this statement, the pathological cases are con- 
sidered to include, besides orthopedic cases (lateral curvature of 
the spine or other defects of the bony structure), those pupils 
who are weak from recent illness, the anaemic and tubercular 
cases that properly belong in a fresh-air class, extreme cases of 
underfeeding or poor nutrition, and those occasional cases of de- 
ficient nervous power, heart weakness, etc., that place a child 
below normal physiologically. It should by no means be inferred 
from the foregoing that no such pathological cases will be found 
in Division I. On the contrary, very many children of all these 
types pass the triple test, and there seems to be no reason why, 
as a result of several terms' work (often less) with these efficiency 
methods, every child not so affiicted, and nfany who are, should 
not be able to pass the test for posture. An improvement in 
the general appearance of health in pupils 'has been noted by 
several principals, and improved posture on the street has also 
been a subject of voluntary comment. 

PATHOLOGICAL CASES. — In testing a class, all pathologi- 
cal cases should be included, except the occasional extreme cases 
that are excused from all exercise on a physician's statement. 
Orthopedic cases, unless excused for reasons explained in Chapter 
VI, should be included in the test, but not counted in any of the 
records, either for attendance, or in the groups. As before stated, 
such children need, perhaps more than any others, every possi- 
ble encouragement to hold themselves in good position ; but even 
if they can do this long enough to pass the test, which is not un- 
usual, they should not be rated, but marked " Medical defect." 
It may be well, however, to encourage such pupils by allowing 
them to sit or stand with Division I. 



CHAPTER XX 

HOW TO CORRECT POOR POSTURE IN THE CLASSROOM : 
TRAINING THE MUSCULAR SENSE 

The triple test, and all else described in previous chapters, is 
merely preliminary to the teacher's real work for posture — the 
corrective teaching through which alone those pupils deficient in 
posture may receive the development they need. This develop- 
ment lies in two distinct Hues: (i) training the muscular sense ^ 
whereby the child knows whether or not he is in the correct 
position and is able voluntarily to assume it ; (2) strengthening 
by exercise those muscles in which weakness allows lapsing into 
poor posture. These two lines of development were explained 
for home conditions in a previous chapter, but may well be re- 
viewed here with directions for adaptation to school use. 

Nothing can be done for posture until the child knows how it 
feels to stand correctly. He must therefore first of all be put into 
the correct position. 

To correct the fatigue position, — the commonest fault of 
posture, — it is necessary to bring the upper part of the trunk 
forward without unduly distending the ribs. This is accom- 
pHshed by action of the joints in the small, or hollow, of the back, 
— a movement that will be found to correct in nearly all cases 
the position of the chest above, and the pelvis below. The only 
parts that may then still need attention are the shoulder blades 
and the neck (head). 

* See Appendix, Note 10. 
214 




Gainsborough 

Plate XXII. — The Ladies Marsham and Honorable Charles Marsham. 
{Collection of Lord Rothschild. By courtesy of Br aim b" Co) 



TO CORRECT POOR POSTURE IN THE CLASSROOM 217 

Just what is meant by bringing forward the upper part of 
the trunk will be seen by reference to Figs. 74 and 75. There 
it is apparent that in the poor position the chest is back of the 
vertical Kne ; the correction is made by bringing the entire upper 
part of the body forward. By actual measurement the abdomen 




Figs. 74-75. — Testing posture with a window pole. 

is not retracted in the corrected position, the distance between 
the front of the belt and the window pole (which serves in the 
illustration for the vertical line) being the same in both pictures. 
There is increased tension in the abdominal muscles, but this is 
incidental to getting the upper part of the body in position, and 
no instructions will be necessary for the position of hips or 
abdomen. 



2l8 



THE POSTURE OF SCHOOL CHILDREN 



CLASS CORRECTION. — These corrections may be made for 
many pupils at once by means of a class exercise as follows: 
Have the entire class stretch the arms strongly sidewise at 
shoulder level, with palms turned downward (Fig. 42). In this 




Fig. 76. — The hands placed for pushing 
the upper part of trunk forward. 



tiG. 77. — Another view of the method 
of correcting the position of the trunk. 



position the pupils should sway forward from the ankles so that 
the weight is nearly or quite over the balls of the feet. Care 
should be taken that this swaying is not misinterpreted as a 
bending at the waist or hips, but is done literally by the ankle 
joints. Swaying backward and forward in this position a few 



TO CORRECT POOR POSTURE IN THE CLASSROOM 219 




times (not rising on toes) will be found helpful through its con- 
trast of the two positions in which the weight may be carried. 
The stretch of the arms, combined with the swaying forward, 
brings the chest over 
the toes, and the arm 
position corrects the 
shoulder blades. If 
heads droop, a fur- 
ther instruction to 
draw the neck or 
head backward (with 
chins drawn inward 
if necessary) may be 
desirable. Holding 
this position for the 
weight, chest, and 
head, the class should 
then drop the arms 
to their natural posi- 
tion at the sides. 
This should leave a 
considerable number 
of pupils in the cor- 
rect standing posi- 
tion. 

INDIVIDUAL 
CORRECTIONS. — After the class exercise just described, 
there will doubtless still remain a considerable number of 
pupils who need individual help in assuming the correct 
standing position. For faults in the drooping or fatigue posi- 
tion, this individual help may best be given with the pupil 





Fig. 78. 



Correcting the head and neck positions by 
pushing in the chin. 



220 



THE POSTURE OF SCHOOL CHILDREN 




Fig. 7q. — Wing shoulder blades on a child 
twelve. 



even by assistance from the 

The shoulder-blade posi- 
tion, which, if hidden by the 
clothing, may be judged for 
extreme cases by the ear 
test described in Chapter IX, 
and also by feehng for the 
fiat back, may need further 
assistance from the teacher. 
In very thin children the 
lower angle of the shoulder 
blades may sometimes be 
felt even when the blades 
are lying flat on the back; 
in such cases the one simple 



of 



standing in profile to the 
teacher. If the upper part 
of the spine be backward, or 
the chest depressed, the cor- 
rection should be made by 
placing one hand, or a book, 
at the waist line in front to 
steady the body, and with 
the other hand at the back 
over the shoulder blades, 
pushing the upper part of 
the body forward (Figs. 76 
and 77). The head and 
neck positions may have to 
be assumed by a direct effort 
on the part of the child, or 
teacher, as shown in Fig. 78. 




Fig. 80. — The same boy voluntarily con- 
tracting the shoulder-blade muscles. 



TO CORRECT POOR POSTURE IN THE CLASSROOM 221 



requisite of flatness determines the correct position. In Fig. 
81 a prominent shoulder blade and its obhque (improper) 
direction are both indicated. The correction may best be made 
with the pupil standing 
with back to the teacher. 
She should then place one 
hand over the round of 
each shoulder and draw 
the shoulder blades back- 
ward and inward toward 
each other, flattening them 
on the back (Fig. 83). 
After being once assisted 
to this position, pupils 
readily acquire the power 
to adduct the shoulder 
blades voluntarily. In 
Fig. 80 is shown an ex- 
treme effort at correction 
of protruding shoulder 
blades ; in a normal posi- 
tion these do not come so 
close together nor touch 
each other. 

For throwing outward 
of the ribs or stomach in 
a mistaken effort to en- 
large the chest, an entirely different method of correction 
is necessary.^ This position may always be detected by 
the exaggerated outward curve of the front of the body and the 

1 See Appendix, Note 11. 




Fig. 81. — Feeling through the clothing (with 
lower hand) for wing shoulder blades. The 
upper hand indicates the direction in which 
the shoulder blade lies in such faulty develop- 
ment. 



222 



THE POSTURE OF SCHOOL CHILDREN 



extreme hollow in the small of the back. The close association 
of spine and ribs, which leads to this position, also indicates 
the best means of correction ; this consists of having the child 

relax the distended 
ribs (Fig. 84), when 
the back (lumbar 
spine) will be seen 
at once to resume 
a normal outline. 

It will be seen 
that with these 
methods of correct- 
ing posture, many 
old stereotyped 
phrases have been 
dispensed with. 
The terms " chest 
high," "chest 
large," ''chest for- 
ward," ''lift the 
chest," "hips 
back," " abdomen 
in," or " shoulders 
back " are associ- 
ated in almost 
every case with 
some exaggerated 
muscular action that, instead of producing good posture, corrects 
one fault by producing another (see Fig. 73). The first four phrases 
lead to the static distention of the ribs and the hollowing of the 
back that has been called the " bantam " or " pouter pigeon " 




Fig. 82. — The ear test for shoulder position. 



TO CORRECT POOR POSTURE IN THE CLASSROOM 



223 



attitude ; the next two lead to an exaggerated tilt of the pelvis ; 
and "shoulders back " is an old enemy of good posture for its 
cultivation of a sway-back position of the entire upper part of 
the body. 

Pupils should under- 
stand exactly what they 
are expected to do, and 
phrases that more ex- 
actly describe this may 
be found useful. The 
moving forward of the 
upper part of the trunk, 
for instance, may be as- 
sisted by the command, 
" Chest over toes." 

POSTURE DRILL. 
— Having thus assisted 
each pupil in a class to 
assume the correct posi- 
tion, the next point of 
importance is to train 
the power to take this 
position independently ; 
for this, pupils must 
learn to discriminate by 
their own muscular 

sense between the feeHng of the correct position and their habitual 
poor posture. To this end a Httle drill on losing and resuming 
the correct position has been found of utmost service. The 
pupils are told to lose their good standing position; in short, 
to relax into any habitual, or relaxed, or exaggerated posture they 




Fig. 83. — Placing the shoulder blades in position. 



224 



THE POSTURE OF SCHOOL CHILDREN 



may choose. After a very brief moment of this relaxation they 
are given the command, '' Position ! " and immediately resume 
the new (good) attitude. This is repeated three or four times in 

quick succession, the teacher 
inspecting the lines each time 
and assisting those pupils into 
position who have not yet 
acquired the full sense, or 
power, to assume it inde- 
pendently. This little pos- 
ture drill on losing and taking 
the good position should be 
given as a systematic feature 
of every lesson, at its be- 
ginning and between exercises, 
when pupils are seen to be 
losing correct form in the 
execution of movements. 

This posture drill, by the 
use of the principle of con- 
trast, trains the muscular 
sense and brings control, 
whereby it enhances the corrective element in gymnastic 
lessons. It unquestionably serves another very useful purpose 
by giving a few moments' relaxation to pupils whose good 
standing position is still so far from natural that considerable 
muscular effort is required to assume or maintain it. 




Fig. 84. — Getting a child to relax the dis- 
tended ribs of the over-corrected position. 




Thorwaldsen 



Plate XXIII. — Hope. 



CHAPTER XXI 

HOW TO CORRECT POOR POSTURE IN THE CLASSROOM: 
CORRECTIVE EXERCISE 

A PUPIL who has acquired the power voluntarily to assume cor- 
rect position, as described in the previous chapter, or even to hold 
it for a time, has by no means achieved it as a permanent charac- 
teristic. The very fact that he has had habitually poor posture 
indicates weakness in important muscles, and an habitually 
faulty coordination between the different wiuscle groups. For 
instance, where the shoulders habitually droop forward, muscles 
on the back that should pull the shoulder blades backward are 
weak. Nothing can permanently overcome this fault of posture 
but exercise that will contract so definitely and repeatedly those 
particular muscles that their tone and elasticity will be improved 
and they will become permanently shortened. While an effort 
of the will, as in the posture drill, may accomplish this same end 
for a few moments, the position is held at the expense of a greater 
neural stimulus than is needed by a healthy muscle, instead of 
being done by the contractile power of the muscular fibers them- 
selves. These weak muscles can be cultivated only by exercise, 
which offers the only permanent cure for such a condition. 

This appHes to every fault of posture from head to foot. 
When the spine is in a faulty position, there is weakness in the 
erector muscles that hold it in the normal attitude, and only 
exercise that restores the right position will reach these muscles 
and strengthen them. When the head is too far forward, there is 

227 



228 



THE POSTURE OF SCHOOL CHILDREN 



weakness in the muscles on the back of the neck that should hold 
it in place. Nothing can make the correct position permanent 
but repeated, definite exercise of those particular muscles. 

It therefore becomes of paramount importance that every 
course of study in gymnastic exercise for schools should contain 
a large percentage of corrective exercises. There are hundreds 




Fig. 85. — A biology class. The molding influence of the high school. 

of gymnastic exercises that are pleasing to the eye, and that make 
a pretty show when a class drills, that are not corrective ; indeed, 
they may cultivate poor posture. This does not mean, however, 
that such exercises may not serve some other purpose than pos- 
tural correction. The corrective value of an exercise is often 
so closely associated with physiological results that the exercise 
is equally valuable for either purpose, and neither one may be 
said to predominate. This is explained in the chapter on home 



TO CORRECT POOR POSTURE IN THE CLASSROOM 229 

exercise, where several exercises are described that are equally 
good for both postural and physiological effects.^ 

A large number of carefully selected corrective exercises is 
not, however, the only requisite for improving posture. These 
exercises must be taken (i) according to a method that favors 
the cultivation of new habits of coordination, and (2) with 
careful attention from the teacher to the basic posture and general 
form of execution of each exercise. These points should be con- 
sidered' separately. 

NEW HABITS OF COORDINATION. — Equally important 
with the cultivation of strength in weak muscles is the estab- 
lishment of correct habits of coordination in the various muscle 
groups. To illustrate briefly, in the habitual fatigue position 
the muscles on the front of the body are tfto much contracted, 
and those on the back too much relaxed. So habitual has this 
relation become, that it feels to be right, and in anything the 
individual does, the faulty relation between these groups will be 
maintained. Whether he walk, or dance, play games, or be 
otherwise active, his bad posture will always be present. To 
overcome this, new habits of coordination must be established ; 
the muscle groups must be habituated to working together with a 
different proportion in their pull and effort. 

Illustrations of faulty and corrected coordination are shown 
in Figs. 86, 87, 88, and 89, which give an upward stretching 
from a " setting up " drill. This exercise is supposed to stretch 
the cramped muscles on the front of the body, expand the chest, 
and serve as a general corrective for faulty posture of the trunk. 

1 By physiological effects is meant the rapid stimulation of circulation, respira- 
tion, and related functions, a stimulation that comes through exercise of the large 
muscles of the trunk or thighs or through precipitant exercises, such as running or 
jumping. 



230 



THE POSTURE OF SCHOOL CHILDREN 



In the first picture is shown an " informal " execution of the 
movement in which no attention whatever is given to form. 
The result is that the old coordinations of poor posture assert 
themselves, and every fault is cultivated and aggravated, in- 
cluding the exaggerated curves of the spine, and the bad positions 
of chest, head, and shoulder blades. In Figs. 87 and 89 this 






Fig. 86. — Upward stretching that distorts the posture. 



same exercise is taken with careful attention to form, and as a 
result it trains new habits of coordination. The harm that 
may accrue from faulty execution of exercises was well illustrated 
in the classes where the new efficiency methods were afterward 
worked out, by a rapid decHne in posture which followed the 
systematic use three times a day of this informal mode of upward 
stretching This form of stretching — or lack of form — was 
part of a two-minute drill that led to a rapid and very per- 
ceptible deterioration in posture until the low percentage was 



TO CORRECT POOR POSTURE IN THE CLASSROOM 231 

reached at which the efficiency methods first found it. A 
change to the correct form for the upward stretching here 
illustrated was one of the features of the new methods, and 
helped to overcome in a few months a very large amount of 
lordosis. 

The establishment of new coordinations is, therefore, one of 




Fig. 87. — Upward stretching that tends to cuhivate good posture. 



the most important elements in correcting posture. It can only 
be done by the pupil's consciously directing each movement into 
the right form of execution. Such conscious direction comes 
only through one type of work — gymnastic exercise, as distin- 
guished from recreative forms of exercise (games, athletics, folk 
dancing, etc.). Further, this gymnastic exercise must be taken 
in response to such signals, commands, cues or admonitions that 
each movement has conscious, definite direction of its muscular 
coordination, and is finished to a full terminal position. The 



232 THE POSTURE OF SCHOOL CHILDREN 

most effective method for insuring such work is what is known 
as command or response work as distinguished from rhythmic 
modes of execution. By response is meant a mode of execution 
whereby each movement in an exercise is a response to some 
signal, as a count or cue (word). In rhythm the terminal 
positions, which, rightly taken, accomplish the only definite 
results for posture, are slurred and weakened, unless the rhythm 
be robbed of its most characteristic quahties and benefits, by 
incessant admonitions from the teacher.^ Rhythm is essentially 
an automatic process, and its tendency in exercise, as in every- 
thing else, is to continue old habits of coordination.^ 

To prove the effect of rhythm, one has only to observe a 
gymnastic exercise taken first to response or commands, and then 
to rhythm. In the latter mode, joints that should be fully 
extended are relaxed ; bendings that should be deep become 
slight ; in short, the movements are slurred and lack that defi- 
niteness, force, finish, and precision which alone can establish 
new coordinations and give definite exerbise to weak muscles. 
It may also be noted in passing, that in most gymnastic work 
(other than with the heaviest apparatus or of the precipitant 
type) such form and precision are equally necessary to secure 
physiological effects, for these come best from the strong muscular 
contractions of finished movements. 

Assuming, then, that one has the proper material and method 
(corrective exercises taken to response or command), it is a mis- 
take to think that these exercises will of themselves pull the body 
into the right position. The matter is better stated in just the 
reverse form : if the body be held in the right position, corrective 

^ The only possible exception is in circular movements, such as club swinging, 
but even here constant admonition is necessary to counteract the automatic 
tendencies. See Bancroft, 4. 2 Lagrange, 82. 



TO CORRECT POOR POSTURE IN THE CLASSROOM 233 

exercises will correct, — i.e. they will contract properly the 
particular muscle groups that they are designed to affect; but 
if the body be in faulty posture when these exercises are taken, 
they will not only fail of their effect, but will cultivate and 
aggravate the very faults they are intended to overcome. This 
brings us to the final and most critical requisite for correcting 
posture. 

ATTENTION TO POSTURE AND FORM DURING EXER- 
CISE. — If corrective results are to be obtained, a teacher must 
observe her pupils throughout a lesson in gymnastics to see that 
they hold the correct lines of posture. The grouping of the 
children for posture here proves of especial value, for it admits 
of group teaching. While the entire class exercises in response 
to the teacher's commands, she may concentrate her attention 
upon that group which is having the greater difiiculty to main- 
tain its posture, and assist, personally or with admonition and 
direction, those who yield to the old muscle habits. 

For example, in the accompanying illustration (Fig. 90) is 
shown an abdominal exercise that, if taken properly, corrects also 
the position of the entire spine, flattens the shoulder blades on 
the back, and brings the chest into admirable relation to the 
rest of the body. Without attention to correct form or position 
in its execution, this same exercise, as shown in Fig. 91, fails in 
its work for the abdominal muscles, and aggravates every other 
fault, whether of spine, head, chest, or shoulder blades. The 
correct form has been achieved by the child through a conscious 
effort to keep his back, head, and arms from drooping ; in other 
words, through his effort to contract the weak muscles for the 
benefit of which the exercise is largely taken. This exercise 
should never be taken in a standing position. The atrocious 
posture so cultivated is well shown in Fig. 11. 



234 



THE POSTURE OF SCHOOL CHILDREN 




Fig. 88. — A group of boys stretching upward " informally." 




Fig. 89. — The same group stretching with attention to form. 



TO CORRECT POOR POSTURE IN THE CLASSROOM 235 

Figures 92 and 93 show another exercise in which the teacher's 
watchfulness will decide between help or harm for posture. 
From a position forward the arms are bent and drawn backward 
at the sides to adduct and flatten the shoulder blades, also bring- 
ing the chest, and, through resistance, the head, into good posi- 





FiG. 90. — An exercise performed so that 
it corrects posture. {This and three 
illustrations following by permission of 
D. C. Heath b° Co., from Bancroft's ''School 
Gymnastics.") 



Fig. 91. — To allow this cannot be called 
" teaching." 



tion (Fig. 92). In the companion cut, inattention to the posi- 
tion of the elbows has led to rounding the shoulders still farther 
forward with accompanying protrusion of the shoulder blades 
behind ; the head has been thrust forward and the chest retracted. 
The execution of corrective exercises so that they do correct is the 
object of all gymnastic work for posture. It is the only means of 
developing weak muscles and changing faulty coordination. 
It is the test of a teacher's teaching abihty, and shows at once 



236 



THE POSTURE OF SCHOOL CHILDREN 



whether she merely gives commands, or uses each exercise for 
accompHshing some definite purpose with each pupiL 

The efficiency methods described in this volume have been 
found to enhance greatly the corrective values in gymnastic 
teaching, for they lead to observation of the individual child in 
a way that the usual class exercises never do. The teacher 
learns to observe the lines of posture throughout a lesson. 





Fig. g2. — Correct 
position. 



Fig. 93. — Incorrect 
position. 



Pupils should always know the purpose of each exercise, and 
work consciously and definitely for the desired result. For in- 
stance, when an exercise is intended to draw the shoulder blades 
together on the back, the pupils should know that fact and 
should feel the exercise at the place indicated. This intelligent 
effort on the part of pupils should enter into their execution of 
all exercises. 

In any discussion of exercise for a school curriculum, the 



TO CORRECT POOR POSTURE IN THE CLASSROOM 237 

fact should never be overlooked that correct posture is only 
one of many lines of development for which school exercise 
should provide. Other types of activity than formal gym- 
nastics are needed for these other purposes; but where large 
numbers of pupils have to exercise in very Hmited space and 
time, the formal gymnastics often become the only possible 
means also for physiological stimulation. Their training of 
inhibition and prompt reactions through response to com- 
mands is also one of their most helpful functions, the value 
of which has many times been demonstrated in fires and 
other school emergencies. 

No physical education, however, can be considered balanced 
which is confined to the formal types of exercise, however 
essential those may be. Recreative fornft are as necessary 
for distinctive purposes of their own — such forms as games, 
folk dancing, dramatic or imitation activities (mimetics and 
story gymnastics), and athletics, which include not only track 
and field sports, but all outdoor exercise, such as walking, 
skating, swimming, etc. These recreative forms of exercise often 
give a larger physiological stimulus, an emotional outlet, and 
an opportunity for initiative on the part of the child than can 
be had in formal exercise. The psychological and social train- 
ing of recreative forms of exercise are invaluable, and no 
program of physical education could be considered complete 
without them. Their greatest limitation lies in their lack of 
power to cultivate erect posture, aside from the indirect aid 
that general vigor may contribute to that end. For this reason, 
recreative forms of exercise can never afford an adequate 
physical education for a large majority of children. The formal 
(corrective) exercise and the recreative are both needed for 
balanced development. 



CHAPTER XXII 
SUMMARY OF EFFICIENCY METHODS 

The efficiency methods for posture described in the previous 
chapters may be summarized as follows : — 

POSTURE SHOULD BE JUDGED by the vertical line test 
for the body as a whole, and by the fiat position for the 
shoulder blades. Using this method for judging the posture at 
each step, — 

THE TRIPLE TEST should be given to each class once a 
month. This triple test consists of trying the child's endur- 
ance for holding good posture by judging the carriage of the 
body in — 

1. Standing position. 

2. Endurance marching (four or five minutes). 

3. Gymnastic exercises. 

GROUPING. — All pupils who hold good posture through 
all three parts of the triple test should stand grouped for each 
gymnastic lesson, forming Division I. Pupils who do not pass 
the test should stand in another group, called Division 11. Any 
pupils who need to change places to accomplish this grouping 
should do so at the beginning of each gymnastic lesson, and re- 
turn to their own seats at the close. 

GROUP TEACHING. — Both groups should take the physi- 
cal training lesson at the same time, but the teacher should 
concentrate her attention largely on Division II, giving such 
individual help as may be needed by the pupils in that division. 
This group teaching should embody the following points : — 

238 



SUMMARY OF EFFICIENCY METHODS 



239 



(a) Each pupil should be put in the correct position and trained 
to assume it voluntarily. 

(b) A posture drill (losing and assuming correct position several 
times in quick succession) should be taken at the opening of 
each gymnastic lesson and several times during the lesson. 
This trains the child's mus- 
cular control and his muscular 
sense of position by using the 
principle of contrast. It also 
gives momentary relief to weak 
muscles that may be held in 
unusual tension. 

(c) The gymnastic exercise 
should bring definitely and 
vigorously into action the mus- 
cles that are weak in poor 
posture, especially those on 
the back of the neck, shoulders, 
and trunk, great care being 
taken that the pupils hold 
correct posture throughout the 
exercise. Pupils should under- 
stand what the exercises are 
for, and work consciously for 
this development. 

INDIVIDUAL RATINGS AND PROMOTION. — Pupils who 
pass the triple test for Division I should be given either the 
highest rating (A) or a passing mark (B) to be determined by 
whether or not their good posture is habitual, or subject to 
slight fluctuations. 

Pupils should be promoted to Division I when they can pass 




Fig. 94. — General contours are easily ap- 
parent despite the clothing. 



240 THE POSTURE OF SCHOOL CHILDREN 

the monthly test, and their pride and ambition should he roused for 
this promotion. 

CLASS PERCENTAGES; RECORDS. — Each month after 
the triple test has been made, the class rating on posture should 
be figured on a percentage basis, by dividing the number of 
pupils who pass the test by the total attendance at the time the 
test is made. This class percentage on posture should be posted 
on the blackboard and also kept, with the individual ratings, in 
permanent form. Pupils should know the percentage of their 
class in posture, and their pride and class loyalty should be en- 
listed for improving it. 

The success of these efficiency methods Hes largely in their 
psychological appeal whereby motive is aroused in the child 
himself, through his desire for promotion (to Division I) and his 
pride and ambition in personal and class ratings. 

SCHOOL OR SUPERVISOR'S RECORD. —A school record 
sheet, showing the monthly percentage of each class, is a very 
important element in these methods. It indicates the condition 
of the subject in the school as a whole, shows for school and class 
any progress or the reverse, and indicates for individual classes 
where help is needed, or praise deserved. 

It will help both teachers and supervisors to keep in mind the 
following questions : — 

1. Do pupils stand in posture groups for each lesson in gym- 
nastics ? 

2. Is grouping revised each month as a result of the triple test for 
posture ? 

3. What is the class percentage on posture ? 

4. Does the class know its own percentage on posture ? 

5. Does each pupil know his own rating on posture ? (A, B, or C.) 

6. Are pupils ambitious to be promoted to Division I for posture 
and to improve the class standard in this subject ? 



SUMMARY OF EFFICIENCY METHODS 241 

7. Are systematic records kept of class and individual ratings in 
posture ? 

8. Can pupils in Division II assume correct posture ? 

9. Can they hold this throughout the gymnastic lesson ? 

10. Is the posture drill (losing and assuming good position several 
times in succession) taken at the beginning of every lesson and two 
or three times during the lesson ? 



R 



CHAPTER XXIII 
AUXILIARY AIDS 

The use of these efficiency methods for posture has led to 
many devices for stimulating interest in the subject — devices 
that are familiarly used for other purposes. 

HOME EXERCISE has been found very effective in some 
instances where poor posture did not yield to the regular school 
training. This exercise is assigned like any other school lesson 
for home work, but much discrimination must be used as to 
whether or not the child can perform the exercises with correct 
positions throughout, as without this power on his part the 
exercises may augment the faults of posture instead of correcting 
them. If he possess this ability, a child may well be required 
to interrupt his study period at home with certain exercises to 
be repeated a prescribed number of times, preferably before a 
mirror. Here again the teacher should use careful discrimina- 
tion in choosing these exercises, selecting those needed for par- 
ticular faults. Head and shoulder exercises are the ones most 
commonly needed. For this purpose exercises may be chosen 
from the regular course of study in gymnastics, or from the table 
of home exercises described in this volume. The caution may 
well be repeated — he sure that the child can hold the correct posi- 
tion while performing these exercises before requiring him to do them 
alone. 

REQUIREMENT FOR SCHOOL HONORS. — Among the 

most effective auxihary helps has been a requirement of good 

242 




Macmonnies 



Plate XXIV. — Nathan Hale. New York. 



AUXILIARY AIDS 



245 



posture for various school honors. For instance, where a '' school 
city " has been organized, with a mayor, council, commissioners 
of departments, police, etc., the eligibility requirements for any 
of these offices have included good posture, as determined by 
the triple test ; some schools have even required an A in posture 
for these positions. For monitorships, positions on the " color 
guard" for flag exercises, and other similar offices, a rating of 




Fig. 95. — A group of well-poised boys. 

at least B for posture has been made a condition. It seems 
eminently fitting that any position that makes a pupil conspic- 
uous should include this requirement. Certainly nothing could 
injure more the respect of pupils for a good physique than to 
put in conspicuous positions examples of poor posture. 

REQUIREMENT FOR ATHLETIC AWARDS. — After- 
school athletics for girls have been made another incentive to 
good posture. Participation in contests for trophies — contests 
that frequently form the cHmax of a season's activities — has 



246 THE POSTURE OF SCHOOL CHILDREN 

been made conditional, among other requirements, on a rating 
of at least B in posture. For admission to the athletic clubs 
no requirements are prescribed by the general organization 
controlling athletics, admission requirements being left to the 
discretion of each principal ; but any girl to receive final awards 
must qualify on posture. This requirement was voted on by a 
large committee of women principals, who agreed that the 
athletics should recognize such a fundamental requisite of a 
good physique. In turn, the requirement gives added incen- 
tive to the work for posture. It is to be hoped that good pos- 
ture may be made a requirement for eHgibiHty for boys' athletic 
contests. 

How far-reaching such a requirement may be, is illustrated 
by the case of one Httle underfed girl, whose posture reflected 
the poor nutrition that was due to carelessness or ignorance 
rather than to want. As a member of a school athletic club, 
the child had looked forward through a winter of folk dancing 
and games to the culminating contest. But, alas ! her little 
drooping head and chest would not stay in position for more than 
a few minutes at a time, and it seemed that she must surely be 
barred from the meet. Finally, the hitherto indifferent mother 
asked the school principal ''what she could do for Amorita's pos- 
ture so she could take part in the athletic contest." " Milk ! " 
said the principal. " Feed her on good milk several times a 
day, and let her have oatmeal and other nourishing food." The 
directions were carried out, and in two months little Amorita 
was so improved that she helped her club to win a trophy, and 
received a victor's pin for herself. 

ASSEMBLY EXERCISES have been made useful for stimu- 
lating interest in posture development. In some schools, while 
classes march in and out of assembHes they pass in review before 



AUXILIARY AIDS 247 

an official, and honorable mention, or other award, is accorded 
the class having the best posture. Class percentages in posture 
are read each month from the platform, or special mention made 
at assembly exercises of the class in each grade or department 
that has exhibited the highest percentage or made the greatest 
gain. 

BANNERS ; TROPHIES. — In some instances a banner or 
pennant is awarded for the month to the class having the best 
record in posture, or to the one that has made the greatest gain. 
One school secured a class trophy which goes each month to the 
record class; at the end of each term this trophy is engraved 
with the name of the class reaching the highest percentage 
(or highest average percentage in case of a tie). 

BADGES AND PINS. — Several schoolt have given a tiny 
ribbon bow made in class, or school, colors to each pupil in Divi- 
sion I for posture, and one zealous teacher furnished emblematic 
pins instead of bows. 

TRAINING JUDGMENT OF PUPILS. — Various methods 
have been resorted to for making the pupils themselves more 
discriminating in the recognition of good and poor posture in 
others. In one school where it is customary for one class to 
furnish entertainment for each assembly, although these exer- 
cises themselves are not competitive, the posture of the pupils 
presenting them has been made a subject of vote by the assembly. 
This vote determines which class shows the best posture for 
each month or term. 

In another school, posture monitors are appointed for each 
gymnastic lesson for each hne or file of pupils. These monitors 
inspect the posture at the beginning of each physical training 
period. A monitor's classmates stand in a given aisle, and he 
walks rapidly down an adjacent aisle making the necessary 



248 THE POSTURE OF SCHOOL CHILDREN 

corrections. When he has finished, the file in question sits and 
the next monitor goes down the vacant aisle and reviews his own 
file. Any pupil in a given row of seats may be called upon to 
serve as posture monitor for that row, the teacher endeavoring 
to train all pupils by this service to discriminate in their obser- 
vation of this subject. 

In some schools, monitors for stair or hall duty have been 
asked to review posture, as well as to look after the usual moni- 
torial duties in conduct or discipHne. 

In a high school, pupils of each class were asked to vote once 
a month on the question of which of their classmates had shown 
habitually good posture throughout the month. It is signifi- 
cant that the highest percentage of good posture was reported 
for the freshman class, just promoted from the elementary schools 
where the efficiency methods herein described had been put in 
use within a year. 

DRAWING AND COMPOSITION. — Good and poor posture 
have been made subjects for drawing and composition, with 
results that were undoubtedly beneficial to the children and often 
amusing to their elders. 

HOME REPORTS. —The custom of making posture a 
special item on report cards sent home each month is spreading 
rapidly, and has led to excellent cooperation and much apprecia- 
tion from parents. Like most things, it has its humorous side. 
One irate mother came to a school to protest against her son's 
being rated on his " looks." " He doesn't come to school," 
she said, " for his looks." It took some time to convince her 
that in this case health and looks were one. 

PROMOTION AND GRADUATION REQUIREMENTS.— 
In the New York City schools posture is noted in the estimate 
of a pupil's proficiency for promotion from grade to grade, and 



AUXILIARY AIDS 



249 



each pupil's posture is rated in estimating his fitness for gradua- 
tion from the elementary schools. Until the efficiency methods 
described in this volume were adopted, as many types of posture 
were passed as " good " as there were teachers or principals. 
The triple test has at once standardized the subject so that a 
rating of A, B or C, carries a definite significance. 




Fig. 96. — Even in the manual training lesson careful work means inevitably stooping 

positions. 

PUPILS' INTELLIGENCE ON THE SUBJECT. — Above 

all, children should be made intelligent not only as to the points 
of good posture, but as to the reasons for it. They should know 
that good posture gives room for the lungs to act and to grow, 
helping to strengthen them so that they can resist disease, and 
properly purify the blood ; that the heart and general circulation, 
the stomach and digestion, are all better when the organs con- 



2 50 THE POSTURE OF SCHOOL CHILDREN 

cerned are given proper room for their work. They should know 
that in poor posture the opposite of all this is true. Children 
are always interested to know that in good posture they have 
their greatest height and that poor posture makes them shorter. 
With occasional cases of overgrown boys and girls, who are 
mortified by their height and shrink into poor attitudes to hide 
it, the power and advantage of large proportions should be set 
forth in private conference and a pride aroused in a physique 
that may be magnificent with correct carriage or ridiculous 

without it. 

POSTURE AN INDICATION OF CHARACTER. — The 

different impressions of intelligence and energy conveyed by 
good and poor posture are readily appreciated by children if 
illustrated for them, and the importance of these in business or 
social Hfe appeals especially to the older children, many of whom 
expect to apply for positions when they leave school. The pride 
of personal appearance has also a legitimate appeal to older 
pupils ; and girls may well learn that the effectiveness of a gown 
depends less upon its elaboration than on the way it is carried 
and worn. 

EXAMPLES OF GREAT MEN AND WOMEN may be 
effectively used in appealing to the intelligence of the children, 
and frequent illustrations may be found in portraiture and ideal 
art. One class of boys and girls who selected " Queen Louise " 
as a class picture, gave as their reason, '' Because she stands so 
well." With pictures of Washington and Lincoln before them, 
of kings and queens, of pioneers and heroes, who figure in his- 
tory and literature, it should not be hard to inspire any child 
with a desire for the best carriage he can cultivate. 




Bartlett 



Plate XXV. — Lafayette. Paris. 



CHAPTER XXIV 
THE SCHOOL HYGIENE OF POSTURE 

Erect posture is at all times closely related to physical and 
mental condition. Indigestion, weakness of the respiratory 
organs, lack of sleep, worry over examinations or promotions, 
any form of nervous or mental depression, — all show in the 
carriage of the body, which in turn may aggravate or alleviate 
the physiological conditions. It seems especially deplorable 
that in addition to these general influence, a growing child, 
who is establishing his habits of posture for life, should be sub- 
jected to the almost constant adverse influences of school life. 
For it is a fact that almost every school occupation, except 
physical training and singing, tends to induce poor carriage of 
the body. 

The sedentary nature of its work is the school's first and most 
persistent enemy to good posture. For this an adequate amount 
of exercise, selected for definite purposes, is the only remedy. 

"In consequence of the neglect of the elementary school to make 
provision for physical exercise, many of the pupils come up to the 
secondar}^ schools with drooping heads, flat chests, projecting shoulder 
blades, and other school bench deformities, which must be attacked 
at once if they are ever to be corrected. Physical defects are so 
common during the early teens, and they are so easily overcome at 
this time, that the whole school class should be put through a daily 
systematic drill with a view to counteracting the evil effects due to 
the confinements and restrictions of schoolroom life." ^ 

1 Sargent, 122. 
253 



254 



THE POSTURE OF SCHOOL CHILDREN 



From the third year up, most school children sit at least eighty 
per cent of the school day, or more than four hours out of five. 
Leaving aside entirely the effect on physiological processes, 
which become sluggish through the physical inaction, the im- 
mediate effect on posture is readily discernible. 

Sitting is, in itself, a 
partial relaxation, and 
its tendency, long con- 
tinued, is to cultivate 
habits of general relax- 
ation and lazy, lounging 
attitudes. So habitual 
do these become, that 
without constant ad- 
monition from the 
teacher, pupils lounge 
against the furniture 
when they stand to re- 
cite, and usually show 
carelessness of carriage 
in marching for assem- 
blies, dismissals, change 
of classrooms, etc. 
Moreover, most school 
occupations call for close 
appHcation of the eyes (Fig. 97) and also of the hands and 
arms in front of the body. This leads to contraction of the 
chest, and drooping forward and downward of the head and 
spine. Reading, figuring, drawing, map study, sewing, — all call 
for these positions; writing, however carefully done under the 
most approved methods, inevitably tends to the same faults; 




Fig. 97. — Shoulders thrust upward by too high a 
desk. (Courtesy of Dr. Scudder.) 



THE SCHOOL HYGIENE OF POSTURE 



255 



even manual training, which- is supposed to give physical reHef 
and activity, continues these same attitudes of close application, 
which are none the less harmful because the child is on his feet. 
These conditions are an inevitable and necessary part of the 
occupations mentioned, and it therefore becomes of paramount 
importance to 
counteract them 
with frequent 
and sufficient ex- 
ercise, and to ob- 
serve with utmost 
care all related 
points of school 
hygiene that bear 
upon posture. 

Adjustable 
school furniture 
is a fundamental 
consideration.^ 
The person who 
will invent a de- 
vice for easily 
adjusting school 
desks and chairs 
will confer one of 

the greatest possible benefits on humanity, for where adjusta- 
ble school furniture is suppHed, the difficulties of adjustment 
almost or quite nullify its possible usefulness. 

The effects of misfit school furniture on posture are shov/n in 
the accompanying cuts from well-known studies by Dr. Scudder of 

iHartwell, 61; Scudder, 125; Shaw, 126; Cotton, 25; Stecher, 129. 




Fig. 98. 



Crouching attitude induced bj^ too low a desk. 
{Courtesy of Dr. Scudder.) 



256 THE POSTURE OF SCHOOL CHILDREN 

Boston. If the desk be too high, the shoulders are unduly 
elevated and the head and chest forced out of position (Fig. 97). 
With a desk too low, the worst possible crouching attitudes are 
cultivated (Fig. 98). A chair too high leads to sliding down 
in the seat in an effort to touch the feet to the floor, and this 
rounds out the back and tilts the pelvis too much toward a hori- 
zontal position ; with a chair too low, the upper part of the body 
collapses into the most aggravated " fatigue position." 

A properly adjusted chair has the seat at the height of the 
bent knee when the foot rests flat on the floor; this places the 
thigh in a horizontal position. The desk should be of such height 
that when a pupil is seated as above described, and the elbow 
bent, the forearm will rest horizontally on the desk surface.^ 
The distance between desk and chair, affecting as it does the 
leaning forward of the pupil to work, the slope of the desk top 
and relation of the desk to the light, the shape and inclination of 
chair back and seat, are all matters that influence the posture of 
children. The Boston School House Commission has recently 
designed a school seat and desk in which all of these points have 
been considered, though perhaps not finally settled. 

The strain put upon the eyes or ears of children defective in 
vision or hearing is reflected strongly in posture, as shown in the 
almost inevitable protrusion forward of the head in such cases. 
This adds another to the many arguments for attention to these 
points of school hygiene and for seating pupils according to powers 
of sight and hearing, that the strain may be minimized. 

With perfectly adjusted furniture there stiU remains the neces- 
sity for cultivating habits of correct sitting. This should be 
with the buttocks pushed back in the seat as far as possible ; 
with this preliminary, the child can then lean back to rest the 

1 If the pupil has to bend forward to work, the desk should be slightly higher. 



THE SCHOOL HYGIENE OF POSTURE 



257 



shoulders without inducing any fault of posture, if the furniture 
be shaped to admit of this. Unfortunately it is well nigh impos- 
sible to find such furniture. The Boston model comes nearest to 
it. Figure 100 shows a temporarily good position in the ordinary 
school furniture. In this position a child can sit upright at 




Fig. 99. — a grammar school boy in a primary school seat. 



intervals without fatigue. The essential value of this sittmg 
position is that it places the pelvis in its natural relation to 
the spine, so that the latter is not forced into unnatural curves. 
The position of the hands and arms when sitting at attention 
ai-e of much importance. The best position is with the hands 
resting naturally in the lap or on the seat at the sides. If for 



258 



THE POSTURE OF SCHOOL CHILDREN 



disciplinary reasons the hands should be in sight, they should be 
clasped on the edge of the desk, as near to the body as possible, 
that the shoulders may not be drawn forward, or the chest 
narrowed by stretching the arms forward. 




Fig. ioo. — Furniture of the right height. 



The habit of folding the arms behind, between the body and 
the back of the seat, should never be allowed. If the buttocks 
and shoulders are kept in the proper position, this folding the 
arms behind forces the spine into the lordosis position (exag- 
gerated lumbar curve) ; for it is a mistake to think a child has a 



THE SCHOOL HYGIENE OF POSTURE 



259 



hollow in the back sufficient to hold the arms in this way. In 
the correct sitting position the natural lumbar curve is almost 
obHterated in children up to thirteen years of age, and nothing 
could be worse for posture than to force it by this wedging of 
the folded arms between the child and the chair back. Other 




Fig. ioi. — Crowded forward in the seat by folding the arms behind. 



faults that come from folding the arms behind in sitting are a 
prying or forcing forward of either the upper or lower parts of 
the spine, so that the pupil sHps forward in the seat (Fig. loi) ; 
folding the arms on the chest, or clasping thern on or behind 
the head (Fig. 102). These positions are equally reprehensible 
for their tendency to drag the chest and head forward. 

It should always be remembered that the natural restlessness 



26o 



THE POSTURE OF SCHOOL CHILDREN 



of children is a need of their growing bodies, and this need should 
be respected by allowing natural shifting of positions in sitting. 
The points essential for avoiding harm, aside from the shape 
and fit of the furniture, are that the child shall be called to the 

erect position with 
sufficient frequency 
and systematic or- 
derliness to avoid a 
habit of relaxation or 
slouching; and, fur- 
ther, that no one 
position of relaxation 
shall become a habit. 
Frequent change of 
posture in either 
standing or sitting, 
and a sufficient al- 
ternation of the two, 
should be among the 
cardinal principles for 
the hygiene of pos- 
ture. 

Writing positions 
are, of course, of 
great importance. 
The best is unques- 
tionably that which 
calls for the support 
of both arms on the desk ; but no position can do away with 
the need for much watchfulness and admonition on the part of 
the teacher during writing exercises. The amount and direction 




Fig. I02. — A sitting posture that needs no comment. 



THE SCHOOL HYGIENE OF POSTURE 



261 



of light, and even the quaHty of pens, ink, and paper, affect 
posture.^ 

The carriage of pupils in standing and marching could be 
made of great service for cultivating good posture instead, as 
is usually the case, of allowing careless, slouching habits to 
obtain. The author knows 
of more than one school 
in which great improve- 
ment in posture resulted 
from the introduction of 
brisk, military methods 
of marching in and out 
of the building, in place 
of a slouching, shuffling 
passing of classes. A fife 
and drum corps, or the 
drum alone, has the same 
inspiriting effect for such 
exercises as for soldiers 
on the march. 

Standing for recitations 
is done so often that it 
becomes one of the ha- 
bitual influences of school life. As such it may serve to fix 
faulty habits of carriage, or be made an effective opportu- 
nity for cultivating the reverse. Standing with the feet parallel 
and the weight equally distributed between them, as described 
for the vertical line test, is not a position that can be long main- 
tained. The tension on the muscles of the legs is .equal, and 
there is no mode of rehef. The usual method of shifting such a 

1 See Abbott, i. "^N 





Fig. 103. 



One-sided 



position from standing 
on one foot — " hip- 
ping out " (Mosher). 



Fig. 104. — The cor- 
rect position for reci- 
tation or. prolonged 
standing — one foot 
in advance of the 
other (Mosher). 



262 THE POSTURE OF SCHOOL CHILDREN 

position is to throw the weight on one foot, the other remaining 
beside it, though perhaps extended to one side. This attitude 
is a harmful one, for it leads to a one-sided tilt of the pelvis, with 
accompanying lateral curvature of the spine, as shown in Fig. 
103 from Dr. Mosher. After careful study of the subject, she 
recommends the position shown in Fig. 104 as one to be assumed 
for school recitations or to reheve any interval of long standing. 
In this the weight is thrown mainly on one foot at a time, but 
the base is enlarged by placing that foot which bears the weight 
•forward of the other instead of beside it. This keeps the pelvis 
level, and, by changing the feet during periods of long standing, 
prevents undue fatigue. The position is assumed by stepping 
sHghtly forward on one foot while the rest of the body is held 
upright. 

The habit of " hipping out," shown in Fig. 103, does not end 
with the period of standing. Such a habit shows also in the 
walk, where almost invariably one foot comes to be planted more 
heavily than the other, or a one-sided swing is acquired. 

Probably no school requirement is more proHfic of bad pos- 
ture than the carrying of books. Could this evil be done away 
with, a large amount of poor posture would probably never 
appear, and that which comes from other causes would be much 
more readily overcome. The schools are rare whose pupils do 
not carry heavy loads of books for more minutes a day than is 
given to physical training. In carrying books to and from 
school, and in changing classes where departmental systems pre- 
vail, these loads literally mold the child into a constant dis- 
tortion of posture. 

Boys and girls carry books differently. Ask a class of boys 
and girls to pack up all of their books and march with them 
around the room, and it will be found that with few exceptions 



THE SCHOOL HYGIENE OF POSTURE 



263 



boys carry the load at full arm's length far around on the hip, 

tipping the trunk to the opposite side (Fig. 105), while girls 

carry the load, as a woman would a baby, farther toward the 

front, shoving the hip out obliquely forward to meet it (Fig. 106). 

The boy's high shoulder will be on the side of his books; the 

girl's low shoulder will be on the 

side of the books. Both attitudes 

are vicious and lead to lateral 

deviations ; but with the girl there 

is added a rotation, by which the 

antero-posterior curves of the spine 

are also exaggerated (Fig. 107). It 

is well-nigh impossible permanently 

to correct the habitual posture of any 

child who is repeatedly distorted with 

such loads. 

The best way to cure this evil 
is to stop carr3ang books alto- 
gether. When it is found that 
five hours a day of close appli- 
cation is enough for a growing 
child, one need for carrying books 
home will be done away with. As 
it is, many schools minimize the 
evil by having the child use a 
systematic method of carrying part 

of the load at noon and part at night. One principal evolved 
the plan of dividing the load between the two arms, carrying 
part on each simultaneously ; it has worked very successfully 
(Fig. 108). Another resourceful principal suggested carrying 
the books on alternate arms on alternate days or weeks. These 




Fig. 105. — Boys and girls carry 
books differently. The boy's high 
shoulder is usually on the side of 
the books, which are carried di- 
rectly under the arm. 



264 



THE POSTURE OF SCHOOL CHILDREN 



methods of carrying books, if systematically carried out, may en- 
able a child to avoid lateral curvature of the spine, but they can- 
not do away with the antero-posterior faults of posture which 
are induced by the carrying of any heavy load. 

Probably the best school bag for books is the German bag 
carried on the back like a rucksack, but it seems hard to make 




Fig. 106. — The way girls carry books — forward on the hip, a position that leads to a 
twist in the spine. When long continued, the low shoulder is usually on the side of 
the books. 



this popular in this country. The hand bags or book straps that 
necessitate carrying the entire weight of books on one side are 
but slightly less harmful than the unaided arm. A habit of 
carrying such bags or straps in one hand shows very soon in 
uneven shoulders. 

In cities where school buildings are used for night school, it 
is common for children to carry all of their books home each 
night, and the author has found many of these loads to weigh 



THE SCHOOL HYGIENE OF POSTURE 265 

ten and twelve pounds. It would be perfectly practicable to 
provide locker room in such buildings for each child. Indeed, 
every school building, whether for elementary or high school 
grades, might well be constructed with such lockers placed under 
the blackboards in the form of drawers. This has been done in 
the case of one New York high school. 

While the topics here discussed have an especially direct in- 






FiG. 107. — Rear view of girls carrying books. 

fluence on posture, there is no phase of school hygiene that is not 
related to this fundamental element of a good physique. Fresh- 
air classes for ansemic and tubercular children improve their 
posture at the same time that they raise the tone of other func- 
tions of the body. School lunches for the underfed show their 
effects in posture as definitely as in other ways. A marked in- 
stance of the effect of such lunches may be cited. The author's 
attention was called to a class of between forty and fifty children 
of the second school year, not one of whom could pass the ear 



266 



THE POSTURE OF SCHOOL CHILDREN 



test for shoulders. It looked as though the test had failed, but 
an immediate inspection of other classes of the grade in other 
schools failed to show similar conditions. This school was in a 
" mixed " neighborhood as to economic conditions, where there 
was a considerable number of children who might be underfed. 
About this time the principal inaugurated the custom of serving 




Fig. io8. — Correction of posture by dividing the load between the two arms. 

a cup of milk in the middle of the morning session to children in 
the lower grades, and this was followed by fifteen minutes of 
" sleeping," with heads on the desks. In a few days a majority 
of the children acquired the habit of taking an actual nap at 
this time. The combined luncheon and rest resulted in such an 
improvement in mental condition as to make the remaining two 
hours of the session available for number work, reading, or other 
tasks usually considered suitable only for the early hours of the 
program. Physically the children responded so rapidly to 



THE SCHOOL HYGIENE OF POSTURE 267 

corrective exercise, that within a month there was scarcely a 
child in the class who could not carry the shoulder blades cor- 
rectly through the triple test. The instance gives pause, with 
the query. How much would the children gain, and how much 
would the waste of education be eliminated, by more general 
use of such simple reenf orcement as a cup of milk and a few min- 
utes quiet rest ? 

All conditions that influence fatigue have direct bearing on 
posture. In this connection, the question of school recesses is 
of special importance. The tendency to omit recesses from the 
school program for grammar grade and high school pupils is 
open to serious objection. When industrial concerns find it to 
their financial interest to give recesses to their adult employees, 
the results showing in improved work ai^d fewer mistakes, it 
would seem that education, in reducing such recesses, is lagging 
behind instead of leading the way. 

Finally, in all matters of home hygiene the teacher can exert 
a strong influence. This is shown marvelously in the degree of 
neatness and personal hygiene often due to the influence of the 
schools. This influence may well be extended to include the 
kind of clothing that affects posture, and all of the other influences 
noted in discussing the home hygiene of the subject. Many 
teachers have influenced girls to sensible dressing, and many 
classes of boys in upper grades have been induced to wear shirt 
waists throughout the winter and sit in the schoolroom without 
the hampering of ill-cut and heavily fined and padded coats. 

The interrelation of these many hygienic influences serves to 
emphasize anew the duty of the-schools, especiafiy under a system 
of compulsory education. A child's health and normal develop- 
ment should be, not only a fundamental, but the fundamental, 
object of his education. 



CHAPTER XXV 
ERECT POSTURE AS AN EDUCATIONAL AIM 

It has commonly been assumed that erect carriage of the 
human body is one of those inherent characteristics for which 
nature cares without any special assistance. To be sure it has 
always been known that many children as well as adults lapse 
from a good position; but that these poor positions might be 
prevented, or that the power to assume and maintain erect pos- 
ture is at the best a very fragile and uncertain one that should 
be strengthened, guided, and helped for all children, whether or 
not their posture deviates from the normal, is a view of the 
matter that yet remains to be incorporated in our ideas of edu- 
cation. 

The details in which proper development of spine, chest, 
shoulders, and feet should be helped during the growing period 
have been set forth in preceding chapters. Further reasons why 
this should not be left to chance may well have a little more 
consideration. These reasons are inherent in some other facts 
of a child's growth. First is the pHabihty of the bony frame- 
work, especially during the years of growth. At this time 
habitual positions, either of rest or activity, may grow into the 
bony structure beyond power of subsequent modification. The 
body is Hterally molded into many of these positions. The 
skeleton is by no means of the hard and unchangeable substance 
which common thought ordinarily assigns to it. The habitual 
strain or pull of muscles, or habitual pressures as of postures, so 

268 




Detail from painting by Brozik 

Plate XXVI. — Columbus. 



{Courtesy of the Metropolitan Museum of Art, New York.) 



ERECT POSTURE AS AN EDUCATIONAL AIM 271 

alter the bones as to decrease permanent height, affect the per- 
manent angle of joints, or change the lines and contours of the 
body. This is especially true of regions that are not ossified 
during these growing years. For instance, the ribs where they 
join the spine are not ossified until late in the high school course, 
or soon after the beginning of the normal school or college (six- 
teenth to twentieth year of age). Portions of the shoulder joint 
and shoulder blade are not ossified until the end of the grammar 
school course or beginning of the high school (fifteenth to seven- 
teenth year). Ossification of the clavicle (collar bone), pelvis, 
and other parts of the body is similarly incomplete during these 
school years. Moreover, the bones in childhood are softer than 
those of an adult, having less lime salts in their composition, and 
as a consequence they yield with especial eaSe to constant pres- 
sure. 

Another element that calls for purposeful education during 
the growing period is the muscular sense, or sense of equilibrium, 
which has frequently been mentioned in this study. ^ However 
instinctive may be the infant's striving for the upright position, 
the fact that the maintenance of this position may not be rele- 
gated for all time to the unconscious nerve centers is plainly 
shown by the faulty attitudes into which children lapse. One 
potent reason for this lapsing lies in the rapid changes in bodily 
proportion during the period of growth. The child's muscles 
no sooner become adjusted to holding upright a comparatively 
large head and trunk on short legs, than his legs begin to grow 
faster than the rest of his body, and soon he is supporting the 
center of gravity on top of long legs with comparatively small 
trunk and head above it. Apparently his arms gain in weight 
faster than the muscles that hold his shoulders in position gain 

1 See Appendix, Note 10. 



272 



THE POSTURE OF SCHOOL CHILDREN 



in strength. The growing period thus becomes a time of con- 
tinual readjustment, and it is no wonder that the awkward boy 
or girl knows not what to do with arms and feet, or that he or 
she fails to estabHsh habits of erect carriage. 

The physical basis of education continually receives fuller 
attention. The need for including in this physical care definite 
training in erect posture has been but feebly stated in this volume 
if its importance as a fundamental requisite to health and physical 
stamina has not been made clear. The time will undoubtedly 
come when tests for a child's physical condition will outrank in 
importance any other tests in his education ; and it is certainly 
as practicable at this time to ask if he stands correctly, and if 
not, why not, as to find out why he goes slowly through the grades, 
or what peculiarity of mind causes him to stumble over prob- 
lems in arithmetic. 




Walker 



Plate XXVII. — Lyric Poetry. 



{Detail from mural decoration in Congressional Library, Washington, D.C. Copy- 
right by H. O. Walker. From a Copley Print, copyright by Curtis and 
Cameron) 



CHAPTER XXVI 

ERECT CARRIAGE AS AN EXPRESSION OF INTELLIGENCE AND 

CHARACTER 

That a person standing erect looks to be more intelligent and 
energetic than one in poor posture, needs no argument ; it is 
self-evident. Under this appearance, giving it reality, Kes the 
biological fact that the erect position has been coincident with 
the development of the brain (cerebrum) as it exists in man. 
While the muscular action necessary for maintaining erect pos- 
ture is chiefly controlled by the unconscious ^erve centers in the 
cerebellum and spinal cord, the acquirement of this posture by 
both the individual and the race is largely the result of direct 
effort by higher brain centers.^ 

That brain development or brain condition bears a direct 
relation to the erect position, becomes apparent when one con- 
siders the collapsed posture and imperfect carriage characteristic 
of idiots and defectives.^ In deahng with a general principle 
like this, however, one must not be led into faulty applications 
of it to individual cases. For instance, habitual poor posture in 
a given individual may indicate, not a low order of brain devel- 
opment, but general lack of nervous or other physical power. 
Barring such pathological conditions, however, it cannot be dis- 
puted that erect posture is, as a general principle, an expres- 
sion of intellect and energy as well as of physical vigor. 

Nor are these the only quahties expressed by a perfectly erect 
carriage ; it indicates, also, many of the -best emotions and traits 

1 Ross, 117. 2 Johnson, 76; Trettien, 138; Seguin. 

275 



276 THE POSTURE OF SCHOOL CHILDREN 

of character, such as cheerfulness, hope, and courage. It is 
the literal as well as the symboUc attitude of Edward Everett 
Hale's famous rule of life: — • 

"Look up and not down ; 
Look forward and not back ; 
Look out and not in ; 
Lend a hand." 

The great actors understand well this effect of erect carriage or 
its reverse in conveying emotions of the higher or lower type. 
Henry Irving as Matthias, the murderer, was a cringing coward ; 
as RicheHeu, Becket, or King Arthur he was drawn up to his full 
height. Richard Mansfield's Dr. Jekyl and Mr. Hyde were as 
different in carriage as in character. And then there is the cu- 
rious fact that the assumption of an attitude expressive of a 
certain emotion tends to produce the emotion. A man recover- 
ing from nervous exhaustion said that when he was breaking 
down, and would find himself sinking into weak attitudes ac- 
companied by depression of spirits, he would pull himself up to 
an attitude of courage, and for hours would be able to go on 
with his work with spirit. This reflex effect of attitude has been 
enunciated by Darwin and others. 

"The free expression by outward signs of an emotion intensifies it. 
On the other hand, the repression, as far as this is possible, of all out- 
ward signs softens our emotions. He who gives way to violent ges- 
tures will increase his rage ; he who does not control the signs of fear 
will experience fear in a greater degree ; and he who remains passive 
when overwhelmed with grief loses his best chance of recovering 
elasticity of mind. These results follow partly from the intimate 
relation which exists between almost all the emotions and their out- 
ward manifestations ; and partly from the direct influence of exertion 
on the heart, and consequently on the brain." ^ 

1 Darwin, 28. 



AN EXPRESSION OF INTELLIGENCE AND CHARACTER 277 

"Movements and attitudes of the body, artificially produced, are 
capable (in some cases, and to a slighter degree) of exciting the cor- 
responding emotions. . . . Remain for some time in an attitude of 
sadness and you will feel sad. . . . Emotion excites movements; 
movements excite emotion." ^ * 

Professor William James says on this point : — 

"Every one knows how panic is increased by flight, and how the 
giving way to the symptoms of grief or anger increases those passions 
themselves. Each fit of sobbing makes the sorrow more acute, and 
calls forth another fit stronger still, until at last repose only ensues 
with lassitude and with the apparent exhaustion of the machinery. 
In rage, it is notorious how we 'work ourselves up' to a climax by 
repeated outbreaks of expression. Refuse to express a passion, and 
it dies. Count ten before venting your anger, and its occasion seems 
ridiculous. Whistling to keep up courage is no mere figure of speech. 
On the other hand, sit all day in a moping posture, sigh, and reply to 
everything in a dismal voice, and your melancholy lingers. There 
is no more valuable precept in moral education than this, as all who 
have experience know. 

"If we wish to conquer undesirable emotional tendencies in our- 
selves, we must assiduously, and in the first instance cold-bloodedly, 
go through the outward movements of those contrary dispositions 
which we prefer to cultivate. The reward of persistency will infallibly 
come, in the fading out of the sullenness or depression, and the advent 
of real cheerfulness and kindliness in their stead. Smooth the brow, 
brighten the eye, contract the dorsal rather than the ventral aspect 
of the frame, and speak in a major key, pass the genial compliment, 
and your heart must be frigid indeed if it do not gradually thaw. 



" 2 



Obviously, the attitude characteristic of courage, intelligence 
and nobility may do much to establish those traits and to banish 
their opposites. 

So many eminent men and women have fine carriage, that 
we have come justly to associate this feature with the highest 

iRibot, 116. 2 James, 75. 



278 THE POSTURE OF SCHOOL CHILDREN 

type of development in the race. The orator who stands in 
poor posture has much more difficulty to impress an audience 
than one who stands correctly A commander must inspire 
confidence by his mien as well as by his words. Men and 
women in the forefront of any fine of endeavor are unusual if their 
power is not indicated in this way. True, there have been, and 
are, many people who constitute exceptions to this rule, but such 
people succeed in spite of a handicap and at an expense of effort 
and energy that is often tragic for the individual, and wasteful 
for the world. 

Artists usually understand the full value of the erect position, 
though they often choose the poses of activity or relaxation.. 
Greek sculpture at its best, when free action in the pose of 
figures had succeeded the stiff, mummy-like erectness of the 
archaic period, shows erect figures always in the full majesty 
of their height. The Parthenon frieze, and the pediment sculp- 
tures from the Temple of Zeus, show many erect figures, and 
these are always in the lines of perfect carriage. Other single 
figures of Greek gods and goddesses owe much of their impres- 
siveness to the loftiness of their bearing. A large part of the 
wonderful buoyancy and spirit of the winged Victory of Samo- 
thrace and of the Nereid group is due in each case to the perfect 
uprightness of the torso. 

The great school of English portrait painters of the eighteenth 
century was very sensitive to this element, and the peculiar 
distinction of the men and women who look from their canvases 
is largely due to their stately carriage. It is almost impossible, 
for example, to find a Gainsborough portrait that is not so posed. 
Although the style of costume shown sometimes disguises the 
fines of the figure, the French, Spanish, and Dutch painters pre- 
sent many other illustrations. 



AN EXPRESSION OF INTELLIGENCE AND CHARACTER 279 

In contemporary art are to be found many examples in which 
the carriage helps greatly in conveying some of the highest 
spiritual quaHties. Most of the figures modeled by Saint- 
Gaudens are fairly electric with physical and spiritual upHft. 
In his Lincoln statue, as Dr. Goldthwait has pointed out, while 
the knees are characteristically relaxed, and the head active 
(bent forward, addressing an audience), the trunk is magnifi- 
cently erect. Both the figures of Saint-Gaudens' Sherman and 
the Angel who leads him toward achievement and victory con- 
vey, largely through their noble bearing, the sense of inspira- 
tion. Macmonnies, in his statue of Nathan Hale, shows, through 
the magnificent erectness of the pose — magnificent in spite 
of the strain of the pinioned arms — the superiority of the spirit 
over death itself. When Walker wished to*typify Lyric Poetry, 
it is inconceivable that he could have done so with a figure 
of imperfect carriage. The song and gladness of the human 
heart, its love and faith and prayer, its loftiest vision and 
noblest aspiration, are depicted in a figure of perfect poise, — 
and all of these qualities education should achieve for the 
children. 



APPENDIX 



APPENDIX 

Note I, Page 4. IMPERFECT ADAPTATION OF THE 
HUMAN BODY TO THE ERECT POSITION. — Among the 

pathological conditions ascribed to the imperfect adaptation of 
the human body to the erect position are appendicitis, hernia, 
gallstones, varicose veins, haemorrhoids, torpid action in the 
liver and ascending colon, and various ptoses, or displacements 
of viscera which lead to derangement of functions. Many of 
the disturbances listed above are largely diie to the difficulty of 
lifting the blood, or other moving masses, liquid or solid, against 
gravitation, — • a difhculty that does not exist in the horizontal 
position, and that, in the erect position, is increased by the pres- 
sures and displacements of poor posture. Dr. Clevenger dis- 
covered that the arrangement of valves in the veins assists cir- 
culation in the quadrupedal or horizontal position, but that 
valves are often lacking where most needed, or, when present, 
sometimes hinder circulation, in the erect position. This fact 
and others noted in Baker's brilHant summary of points in which 
the body is as yet imperfectly adapted to the erect position, 
furnish some of the strongest arguments for good posture and 
exercise. As Baker says, " Adaptation to the erect position is 
still going on and is far from complete." Small wonder that it 
needs to be an object of education for every child. 

Note 2, Page 9. THE VERTICAL LINE TEST, as here used, 
is a practical means of determining the large, fundamental facts 
of bodily poise. Such a mear.s is essential in educational work, 

283 



284 APPENDIX 

where the posture of large numbers of children with clothing on 
has to be judged by teachers not trained in scientific technical- 
ities of the subject. Under such circumstances even the trained 
expert must have some simple, effective method of determining 
the larger facts of posture. The vertical line test is a syn- 
thetic method which includes at a glance the entire body, as 
distinguished from the analytic methods in which one detail 
after another is considered. The vertical Hne as a standard of 
comparison for erect posture has been used before, but not, 
within the author's knowledge, just in the way here described 
for parallehng the apparent axes of the large segments and 
determining the distribution of the weight. Orthopedists have 
commonly used a vertical line for judging lateral deviations in 
scohosis, wry neck, etc., and in 1902 Dr. Robert W. Lovett, of 
Boston, published a method of using a vertical Hne in observation 
and record of antero-posterior deviations.^ By means of Dr. 
Lovett's method is measured the distance from a vertical hne 
of certain bony landmarks ; namely, the middle of the mastoid 
process, the spine of the vertebra prominens, the spine of the 
seventh dorsal vertebra, the spine of the fourth lumbar vertebra, 
the middle of the great trochanter, the middle of the head of the 
fibula, the middle of the external malleolus. This method of 
detailed measurement serves to indicate in some important par- 
ticulars the improvement of posture from treatment, and in 
records accumulated through its use gives a basis for the study 
and classification of certain points which may help to estabhsh 
their relation in normal attitudes. It is not, however, a quick, 
practical, working method such as a teacher might use with a class 
of children. 

Some physical trainers have long made a different use of a 

1 Lovett, 92. 



APPENDIX 285 

vertical line in judging the standing position, claiming that 
such a Hne should fall through certain landmarks, as ear, hip 
joint, ankle, etc. These landmarks, however, have varied with 
different instructors, being empirical in origin, and the method 
has the disadvantage of calHng attention to many details, instead 
of to the larger facts of poise as a whole. 

The vertical line test as used in the present work, by showing 
the direction of the axes of the large segments of the body, com- 
bines at once the methods of the artist and the scientist. From 
the scientific standpoint, the segments chosen are those indicated 
in poor posture, where the cervical vertebrae form a distinct 
axis as shown by the outlines of the neck, or even blend with the 
upper dorsal vertebrae ; and the line or axis of the trunk below 
these follows the direction of the exaggerated backward slant of 
the lower part of the dorsal curve blending with the lumbar 
curve. At the same time it allows leeway for minor individual 
variations, and is not dogmatic on any of the technical points 
on which experts are not agreed, such as the degree of obliquity 
for the pelvis. 

The apparent vertical axis of the trunk in an erect position, 
and the continuation of it through the cervical spine, as prescribed 
in the vertical line test, is easily detected by the eye. Indeed, 
the technical expert, even though searching for a norm by means 
of study and classification of various types of standing, has had to 
rely, meanwhile, on his own recognition of equifibrium, as de- 
tected by the eye, to know when his patients had corrected 
antero-posterior faults of posture. In other words, while the 
orthopedist and physical trainer have heretofore emphasized 
details of postural defects in their formulated study or instruc- 
tion, they would seem in practice to use a quicker, synthetic 
method which at a glance gives a general estimate of the larger 



286 APPENDIX 

diameters of the body. This is also the usual method, worked 
out with plumb hne, by which artists have modeled. and painted 
perfectly poised figures. 

That the apparent diameters as a whole may be readily de- 
tected by the lay worker and that they form a thoroughly practi- 
cable means of determining posture, has been proved by the 
facility with which 5000 teachers as well as children themselves, 
have mastered the method. The success with which teachers 
have learned to judge of posture by this method is shown in the 
fact that, after a year's use, the judgment of the experts differs 
from that of the average class teacher only in from one to four 
cases in classes of fifty pupils, and in a very large number of 
classes the judgment is the same. The author has never seen 
such results from the use of the conventional analytic methods. 
Any one, then, who can teach drawing, or who has an equally 
accurate eye, can use this synthetic method of judging the poise 
of the body, thereby detecting whether or not the axes of the head 
and trunk be vertical, and whether or not those axes line up 
with the rest of the body. 

It will be noticed that the term '' apparent vertical axis " is used 
for the trunk, for anatomically the axis of the abdomen follows 
the line of the lower part of the dorsal curve, and the axis of the 
pelvic cavity joins this at right angles.^ These unapparent 
anatomical details, however important for the expert, are non- 
essential for perception of the posture of the trunk as a whole, 
and when explained to the lay mind only lead to confusion, so the 
apparent vertical axis only is here referred to. 

It will also be noticed that no exact point is mentioned in front 
of the ear, or in the forward part of the foot, where the vertical 
line for poising the weight should be placed. This avoidance of 

1 Goldthwait, 48; Dickinson, 31 (both after Corning). 



APPENDIX 287 

dogmatism on detail was found necessary, as in working out this 
test with several hundred pupils, the author found that the 
position of the weight Hne in relation to ear and foot might- vary 
from zero to one inch, and in a very few cases even more. Or 
stated differently, it was found that if the hne were placed exactly 
in front of, and touching the ear (lobule), it would in many sub- 
jects fall through the ball of the foot, but in many others a line 
so near the ear would require too much of a forward incHnation 
of the entire body if dropped to that point within the foot. 
This would give, not an impression of perfect uprightness, but of 
a falHng forward. The hne serves its purpose of forming a 
parallel to the vertical axis of trunk and neck wherever placed in 
relation to the ear, so its distance from the ear for determining: 
the poise of the weight is left for individujj adjustment. It is 
found that the teacher's sense of the general uprightness of the- 
figure may be trusted for placing this line. Indeed, after some 
practice, the literal use of a tangible line becomes unnecessary. 
The place where the line should fall in the foot is another point 
on which some slight degree of variation has to be allowed. 
There are differences of opinion among orthopedists as to what 
part of the foot should bear the main weight. It has become a 
tradition in physical training that the main weight should be on 
the balls of the feet. Drs. Lovett and Reynolds, however, place 
their line of gravity in the middle of the foot, measured from toe 
to heel (see Fig. 9), so that it falls through the arch, but other 
authorities place the main hne of the weight anywhere from the 
malleolus to the metatarsal joint. There would seem no room for 
difference of opinion on the necessity of the weight being borne 
partly by both supports of the arch (heel and ball of foot), and 
as a mechanical principle the Hne of gravity should presumably 
fall midway between these two points. As a matter of practice, 



288 APPENDIX 

however, there can be httle doubt that a very large number of 
people carry the weight habitually too far backward, thus throw- 
ing out of their proper relation the thighs and pelvis, and dis- 
turbing the balance of the whole figure in a way that involves the 
carriage of spine, chest, and head. It therefore becomes advisable, 
as a teaching principle, to emphasize the forward carriage of the 
weight, and it was for this reason that, in adapting the vertical 
hne test, this Hne was placed in front of the ear and in the 
forward part of the foot, instead of through the mastoid process 
and down into the astragulus as sometimes used in orthopedic 
demonstrations. By the term " forward part of the foot " is 
meant, therefore, any point from the middle of the arch to the 
ball of the foot. This leaves room for those variations in posi- 
tion that may be neccessary from the different placing of the 
center of gravity in different individuals. 

The use of the vertical line test as here given had been worked 
out by the author and used for a year before knowing of Dr. 
Lovett's balance for determining the line of gravity. It is more 
than interesting to note the coincidence between the vertical 
hne of the first-mentioned test and Dr. Lovett's line of gravity 
shown in Fig. 9. So nearly ahke is the position in which they 
are placed that the vertical line test, besides serving its purpose 
of furnishing a parallel for the diameters of the large segments 
of the body, and the proper placing of the weight on the feet, 
may be said also to approximate the hne of gravity. 

Just what constitutes the normal erect position as regards the 
proper relation to each other of anatomical points, has never 
been definitely formulated. Physical trainers, one of whose 
main duties is to cultivate good posture, have had almost as 
many formulas for changing the relation of parts as there are 
instructors, the one uniform point of procedure being the atten- 



APPENDIX 289 

tion to analytic detail. Some of the customary phrases for these 
details are as follows : head up, head high, head tall, chin in, 
neck against back of collar ; chest up, chest high, chest forward, 
chest large, chest out; hips back, abdomen in, " stomach in," 
skirt tipped down in front. The term " shoulders back " is 
found almost exclusively among laymen; indeed, physical 
trainers usually bend every effort to stop its use, as the throwing 
backward of the trunk to which it leads is most objectionable ; 
but, unfortunately, no other term effective for correcting the 
position of the shoulders seems heretofore to have been sub- 
stituted. After an extended experience with nearly all the 
phrases mentioned, the author has discarded most of them, for 
the main reason that the standard of posture that resulted 
from their use was far from satisfactory. Apparently there 
was needed some more direct and fundamental way of appeal- 
ing to the child's muscular control. This was found in the 
methods described in Chapter XIII, in which the correct 
position is assumed (with or without assistance) without the use 
of such cues or phrases, the latter (few and selected) being used 
when needed after the muscular sense of position has been aroused, 
and not before. The larger, synthetic method of recognizing 
posture through the vertical line test has proved vastly more 
effective for teachers. Further, in trying to meet the teaching 
problem of appeaHng to the child with phraseology that will 
lead to the right result, and not to exaggerations, it has been 
found that most of the conventional phrases have led to a neuro- 
muscular action as faulty as the position they were intended to 
correct. The few phrases that have been found free from objec- 
tion are given in the chapters on how to correct posture. 

Among orthopedists there has been similar lack of formulation 
or agreement as to many analytic details and their relations in 
u 



290 APPENDIX 

good posture, such as the normal variations in the curves of the 
spine, tilt of the pelvis, etc. In 1902, Dr. Lovett, after a careful 
survey of English and foreign literature on the subject, wrote : — ^ 

" The common type of faulty attitude, the one known as ' round 
shoulders,' has received very scant attention in American and English 
textbooks on orthopedic surgery. ... In German, on the other 
hand, are numerous articles dealing not only with the normal 
attitude in standing, but with variations from the normal. But 
even here there is but little agreement as to what the normal 
attitude is." 

All the more need for some large, simple, practical criterion 
for educational use pending the formulation of further details. 

The need for considering the whole figure instead of any limited 
section of it, in order to arrive at correct conclusions on posture, 
is indicated in the following passage from the same article : — 

" The difficulty with the classification of faulty attitudes seems 
to be that the antero-posterior outline of the spine alone has been 
chiefly considered and but little or no attention has been paid to 
the relation of the feet, legs, and pelvis to the spine, and of the 
whole body to the perpendicular. And, again, no uniform system 
of measurement has been in use. Under these conditions have 
been only parts of the problem formulated. The general attitude 
is likely to be imperfectly represented by any drawing or observa- 
tion of the spine alone, because it is obvious that a backward curve 
of the upper part of the spine cannot occur without disturbing the 
normal relation of all the supporting structures below it. Equilib- 
rium must be maintained, and the necessary adjustment involves 
feet, legs, and pelvis in their relation to the spine and to the 
perpendicular." 

Note 3, Page 10. CLASSIFICATION OF FAULTY POSTURE. 

— The four types of faulty attitude here given are those into 
which all of the main faults of posture may be grouped. With- 
in each of these groups are many minor variations, or combi- 
nations of elements, which various orthopedists have tried to 

^ Lovett, 92. 



APPENDIX 291 

classify under distinctive names, but without any general agree- 
ment except that an exaggerated lumbar curve shall be called 
lordosis, and an exaggerated dorsal curve, kyphosis. For a 
review of these classifications, see Lovett, 92. 

For practical teaching purposes in schools, a closer analysis 
or classification of faulty posture than that suggested in the 
present volume appears to the author superfluous, however im- 
portant such work may be for scientific purposes. If the long 
axis of the trunk, including the neck, conform to a vertical fine 
as here described, and if the shoulder girdle be placed in position, 
the various parts almost invariably fall into normal relations, 
and the antero-posterior deviations are automatically corrected. 
It therefore matters not for practical teaching purposes whether 
the habitual posture was a " round back," a '*round hollow back," 
a " hollow back," or any other of the types for which names 
are as numerous as the possible arithmetical combinations of 
the elements involved. 

See also Appendix, Note 11. 

Note 4, Page 19. CENTER OF GRAVITY IN THE HUMAN 
BODY. — The balance of Reynolds and Lovett would seem to 
place the center of gravity farther forward than shown by pre- 
vious investigations. They say: "' Up to the time of this, our 
contribution to physiology, there had existed, so far as could be 
learned from a study of literature, no rehable method of estimat- 
ing the position of the center of gravity of the body in the up- 
right position. Various loose statements as to its location are 
given in literature, and there are a few carefully formulated 
attempts to determine it by a study of the masses of the body 
post mortem and their relation to each other, but scarcely 
any two writers agree as to what the erect normal posture 
should be."^ 

1 Reynolds and Lovett, 115. 



292 



APPENDIX 



" So far as the observations by this method have gone, they 
show that in the erect position the center of gravity of the body 
Hes in front of the ankle joints, which are held in dorsal flexion in 
this position by the gastrocnemius muscles. The center of gravity 
lies also in front of the knees, which are similarly held in position 
by the hamstring and quadriceps extensor muscles. The center 
of gravity lies also anterior to the sacroiliac joints and most of 
the vertebral joints. The position of the acetabula cannot be de- 
termined in the erect position in the living individual, because we 
have no means of locating them from any available landmarks. 
If we were able to determine the position of the acetabula in the 
antero-posterior plane, it would be possible to state definitely, from 
the relation of the center of gravity to them, whether the trunk in 
the erect position would tend to fall forward or backward at their 
level." 1 

Dr. Lovett concludes, however, from other experiments, that 
the trunk would fall forward but for the " combined and con- 
tinued action of the posterior musculature, the chief factors 
here being the hamstrings, the glutei, and the erector spinae 
muscles." 

A summary of work on the center of gravity previous to that 
of Reynolds and Lovett will be found in S chafer, Physiology. 
See also Hall, Adolescence, Vol. I, p. 61, and bibliography in 
Lovett, 86, p. 172. 

Note 5, Page 33. THE RELATION OF ABDOMEN AND 
THORAX IN RELAXED POSTURE. — The author is inclined 
to think that unless there be abnormal outlines from sagging 
viscera, the protrusion of the abdomen in relaxed posture is more 
apparent than real, — an appearance produced by the backward 
sagging of the thorax. In correcting the position, and bringing 
forward the upper spine, there is a tightening of the abdominal 
muscles, but these act on the front of the pelvis as a fixed 

1 Lovett, 86. 



APPENDIX 293 

point, and bring the thorax forward rather than draw the 
abdomen backward. There may also be a change in the tilt 
of the pelvis, but apparently not in its total antero-posterior 
position, for it is noticeable that when the thorax is brought into 
position, with the weight of the entire body poised vertically, 
the abdomen has not changed its relation to a fixed vertical Hne. 
This is shown in Figs. 3 and 4 by observing the relation of the 
front of the belt to the vertical hne ; it is exactly the same in 
both the poor and corrected positions, although the relation of the 
anterior wall of the thorax to the test Hne has undergone a decided 
change. For this reason, in trying to get the right relation be- 
tween the upper and lower parts of the trunk, the author has 
stopped using with children the terms " abdomen in," or " hips 
back," finding that the phrase which more^nearly expresses the 
main action involved, " chest over toes," secures with much 
more definiteness the actual muscular action desired. 

A study of this relation of the relaxed abdomen to the Hnes of 
correct standing, under freer conditions for anatomical study 
than those afforded by the public elementary schools, would be 
desirable, especially in view of the prevalence of the custom of 
correcting the relation between pelvis and thorax mainly by an 
attempted retraction of the abdomen. 

Note 6, Page 55. CORRECT BALANCE OF THE HEAD. — 
The vertical position of the neck seems to be determined by the 
fact that the head is supported on the odontoid process of the 
axis, which should be vertical to support it with the least ex- 
penditure of energy. Gray's Anatomy says, '' The Hne of gravity 
of the head passes through the middle of the odontoid process of 
the axis." 

Note 7, Page 65. CHEST PROPORTIONS, OBLIQUITY 
OF RIBS, etc. — Most interesting is the summary by Dr. 



294 APPENDIX 

Woods-Hutchinson of the widening of the chest in the biological 
series, according to the uses of the forelimb, and the assumption 
of the erect position (Hutchinson, 68, 69). A condensed 
account of this is here quoted: — 

" As all are aware, the human chest is, with one or two exceptions 
(the bats and the whales), almost unique in the animal kingdom, in 
that its transverse diameter is the longer, and this, of course, is 
obviously associated with the locomotive necessities of the anterior 
limbs in the quadrupedal and the erect positions respectively. The 
animal or quadrupedal chest having to be carried between the 
parallel-moving anterior limbs, naturally disposes its air space in 
the shape of a box, having as little width in its anterior part as 
is consonant with sufficient heart room and general vigor. Of 
this the f amiUar ' deep ' chests of the hound and of the race 
horse are illustrations that will occur at once. It may be remarked 
in passing that in every order of vertebrates it is the exigencies of 
locomotion which seem to determine the shape of the chest. Even 
before lungs are present, it is ' deep ' in the earlier forms, the fishes, 
for obvious ' yacht-shaped ' reasons ; rounded in most amphibians 
and reptiles which crawl flat-bellied, with legs (if present) wide 
apart ; rounded in birds with their wide-apart wing attachments, 
although crested with a great keel which gives it an opposite ap- 
pearance ; ' deep ' again in all quadrupeds with their parallel-moving 
anterior limbs, but flattening out in the fliers, like the bats, the 
pure swimmers, like the whales, and our own biped-climbing, upper 
families, the apes and man." ^ 

Dr. Woods-Hutchinson suggested the " chest index " as such; 
that is, the application to the chest of the method of determining 
relative proportions that had previously been used for the cra- 
nium. Dr. Dwight had previously used a somewhat different 
method of stating the relation of antero-posterior chest measure- 
ment to the lateral diameter. He says, " The want of breadth 

^ Hutchinson, 69. 



APPENDIX 295 

[in the infant chest] is very striking, while in the adult, throughout 
the chest below the level of the second costal cartilage, the an- 
tero-posterior diameter is to the transverse as i to 2 J or as i 
to 3."! Dr. Sargent says : " At the age of six or seven years 
the diameters at the shoulders, the chest, and the hips at the 
trochanters are doubled. The diameters of the trunk with 
respect to thickness grow less rapidly. The diameter of the 
chest from front to back becomes doubled only toward the age 
of puberty, and from birth it grows only in the ratio of i to 2.36. 
The circumference of the trunk grows in almost the same pro- 
portion as the height and transverse diameters." ^ 

In his study of relative proportions of the body and their 
significance in education. Dr. Tyler has independently arrived 
at the index method of estimating chest proportions. These 
proportions are mentioned in his work on " Growth and Edu- 
cation," and more in detail in lecture syllabi. 

Dr. Hastings says : — 

"Chest expansion depends ;iiore upon increase in lateral than in 
antero-posterior diameter. This fact is indicated by breadth of chest 
taken during mean normal respiration, but is fully demonstrated only 
when breadth of chest is taken during full inspiration." "Since by 
reason of the points of attachment of the ribs the respiratory move- 
ment is of necessity greater in the lateral plane, the greater the obliquity 
of the ribs, the more pronounced the movement during respiration, and 
hence the greater the chest expansion." ^ 

The chest index would seem to be destined to important con- 
sideration in anthropometric work, especially in view of its 
relation to tuberculosis, as shown by the work of Dr. Woods- 
Hutchinson and collaborators. 

The slope of the sternum in adults is given as from twenty to 

1 Dwight, in Piersol, Anatomy, 157. ^ Sargent, 122. ' Hastings, 63. 



296 APPENDIX 

twenty-five degrees.^ In Fig. 39 it is thirty degrees. The slope 
of the sternum in children has not been studied, so far as the 
author has been able to trace, but it is obviously considerably 
less, being a factor in the rise from the sixty-three per cent depth 
of the fiat- chested age (eleven to fifteen years) to the seventy 
or seventy-two per cent of adult proportions. 

Note 8, Page 173. CORSETS; HIGH HEELS. — Drs. 
Reynolds and Lovett classify corsets for their effects on posture 
as bad and as good. The common characteristics of bad corsets 
they describe as follows : — 

"i. They are long behind (especially at the top) and short in 
front (especially at the bottom). 2. They are cut to exert their 
greatest pressure at the waist, and at the top and bottom are capable 
of exerting pressure only against the wearer's back. 3. They have 
strongly marked sacral curves [i.e. outward behind over the buttocks], 
but are otherwise straight in the back, and are highly incurved at the 
waist in front." The common characteristics of the corsets classed 
as " good " are : '' (i) that they are short behind (especially at the top), 
and relatively long in front (especially at the bottom) ; they fit the 
wearer tightly around the pelvis (especially in the space between the 
iliac crests and the trochanters) and decrease regularly in pressure to 
their upper edge where they are very loose (especially behind); 
(3) they are considerably incurved at the waistline at the back and 
sides, but show no waist curve in front." These points are amplified 
as follows: ''The corset should fit very tightly in the space between 
the trochanters [top of the thigh bone near where it joins the pelvis] 
and the iliac crests [top of the hip bone or pelvis]. This anchors the 
corset and in many figures prevents its riding up without the use of 
the objectionable front garter. It should merely fit [i.e. set to the 
figure, but not tight] over the iliac crests and immediately above 
them, as tightness at this point is uncomfortable and makes the corset 
ride up. In the back it should fit the hollow of the waist snugly, 
being hollowed in at the back, but not at the front, and above the 
waist it should be left as loose as the patient will wear it. In the 
front it should be straight without constriction at the waist. . . ." 

1 Gerrish, 151 ; Morris, 156. 



APPENDIX 



297 



" The anterior bones should run from above downward and strongly 
forward. ..." 

"To be properly applied, a corset should be laced in three sections, 
sacral [the outward curve over the hips or buttocks in the back], 
lumbar [the hollow of the back], and dorsal [over the shoulders]. 
Before it is put on, all the lacings must be widely loosened. The 
corset must then be settled into place as low as it can be worn and 
clasped. The patient should then pass the hand inside it and lift 
the abdomen into it, settUng the front of the corset as low as 
possible. The lumbar lacing should be pulled comfortably snug. 
The sacral lacing should then be made as tight as can be borne, and 
if the corset is so made as to spare the iliac crests, and properly 
cut out for the thigh in front, very tight lacing around the solid 
pelvis is comfortable. . . . The dorsal lacing should be left as loose 
as possible." 

Dr. Dickinson, as the result of tests and observations extend- 
ing over many years, and much original work in testing the 
pressure exerted by different types of corsets at different points, 
gives detailed directions from which the following are taken : — 

" In general there should be the least possible downward pressure 
on internal organs ; no undue tightness, and no forward carriage or 
droop of chin, as a result of wearing a particular corset." 

" The designs to be preferred show the front straight, with httle 
or no incurve at the waist, long below, reaching nearly to the pubic 
bone ; back curved, low at top ; separate lace for lower six or eight 
holes." 

"Pressure should be greatest around the hips, carefully and snugly 
adjusted, diminishing above this zone, being less at the waistline than 
below the waist. The lower ribs must have play. With regard to 
posture or carriage, the shoulders must not be thrown forward and 
hips backward," the position being judged first by standing correctly 
without the corset, and then after it is put on. . . . " The above 
apphes to the dress corset. For active work a very flexible, short, 
loose corset may be worn, or merely shoulder straps to support the 
skirt." 



298 APPENDIX 

Dr. Dickinson advises that the first adjustment of a corset 
be made with the wearer lying down. 

As to tightness, Dr. Dickinson considers that for adults, 
except in cases of special weakness, a corset that springs open 
two and one half or three inches when unclasped does not show 
an excessive pressure, if that pressure be distributed as pre- 
viously explained. 

It should not be inferred that any of the physicians quoted 
on this subject consider even the best corset harmless, or as 
good as entire freedom from such restrictions. Dr. Dickinson is 
very outspoken on this subject and does not agree with his 
confreres in calHng any corset ^' good." The latter plainly 
state that their study relates entirely to the relation of the corset 
to posture and leaves out all other considerations. Dr. Dickin- 
son finds that the type of figure or build makes a difference 
in the possible harmfulness of corsets. On this point he says : — 

" The muscular and active woman, with abdominal walls of good 
tone, and pelvic floor firm, . . . with internal organs normally 
anchored and no great fat padding, — this type is little harmed by 
corsets. The relaxed woman, long-bodied, her lower chest easily com- 
pressed, her internal organs lacking fat cushions that are adequate 
and supports that are resilient ... is commonly harmed by corsets." 

Dr. Dickinson's article in particular is profusely illustrated, 
showing, among other things, the types of permanently distorted 
figures that are beginning to be seen in art, for which corset 
deformed models have posed. When the author of the present 
work spoke of the use of such models to an official of a prominent 
art school, asking why such models were used, misleading pupils 
as to the correct lines of the figure, the answer was, " But it is 
almost impossible to get models of unspoiled figures." ^ 

^ See Dickinson, 31; Reynolds and Lovett, 115; Mosher, 102; Galbraith, 44. 



APPENDIX 299 

Drs. Reynolds and Lovett found that high heels tend to re- 
store the equilibrium lost through corsets that throw the figure 
out of true. Such heels lead to an unnatural straightening 
backward of the body to offset their primary tendency to tip it 
forward. Whatever the effect on equihbrium may be, the lack 
of freedom and grace of movement is obvious. There is also an 
unavoidable strain on hgaments throughout the body. 

Note9, Page 188. MOTIVATION OF PUPIL'S WORK. — 
Teachers will appreciate the significance and power of motiva- 
tion of children's work, and the difference between motives and 
incentives. In his " Report on the Motivation of the Children's 
Work in the Elementary Schools," Mr. H. B. Wilson, Super- 
intendent of Schools in Decatur, 111., says: — 

" The largest problem in the technique of teaching is that of sup- 
plying adequate motives for the work of pupils. The psychological 
rather than the logical organization and presentation of the school 
curriculum contributes to the motivation of school work. The pu- 
pils' needs and interests are the natural and safe avenues through 
which to lead them into that response to the best social standards 
and into those abilities which are essential to effective social partici- 
pation. School work is meaningful and significant to pupils to the 
extent that it contributes to the satisfaction of needs, immediate or 
remote, that are real to them. 

'^\n incentive is characteristically something to be had following a 
series of efforts, but the thing gained is not produced by, or developed 
through, the effort expended. Rather, the thing gained is external 
to, or outside of, the immediate result produced by the effort. In- 
centives range, to be sure, from the most material, mercenary prize 
to the loftiest social and spiritual gift, or reward, man can confer. 
The effect of an incentive is to move the mind, stir the passions, and 
cause action. It is, however, as noted above, external to the direct 
results produced by the acts it excites. It stimulates one to efforts, 
much as martial music quickens the step and strengthens the courage 
of the soldier, inspiring him to do his duty, even in the face of grave 
danger. . . . 



300 APPENDIX 

''A motive is not an external reward conferred at the conclusion 
of a series of efforts ; . . . The distinctive mark of genuine motive is 
that the contemplated end is produced by, and realized as, the results 
of a series of efforts. ... 

" My experience as a boy on the farm definitely illustrates the 
operation of a genuine motive. For the work I did in gathering and 
marketing the butter and eggs, I shared the profits derived from the 
production and sale of this produce. This profit was the ' gratifica- 
tion contemplated ' ; it was my goal. It caused my effort, and this 
effort produced the contemplated end (the profit) which served to 
motivate my acts. Whether one's motive be to earn money, write a 
letter, assist his classmates, or delight his parents, it operates simi- 
larly, generating the effort which, if successful, enables him to realize 
the longed-for end. ... 

" It is evident, perhaps, that whereas incentives are superficial and 
external in relation to one's efforts, motives are fundamental and 
vital in determining effort ; one is held before the child to stimulate 
him, while the other arises out of his own efforts in self-expression 
and self-realization. Any motive operates as an incentive, but no 
mere incentive constitutes a genuine motive." — Proceedings National 
Educational Association, 191 1. 

A previous report and discussion of this subject will be found 
in the N.E.A. Proceedings for 1910. 

Note 10, Page 214. THE MUSCULAR SENSE. — By the 
muscular sense is here meant a sense of the position of the body 
or any of its parts, or of the force or amount of muscular contrac- 
tion necessary for any position or movement. 

" It is somewhat difficult to present a precise definition of the 
term ' muscular sense.' Authorities have not been perfectly 
concordant in their use of the term. It may perhaps best be 
taken to include all reactions on sense arising in motor organs 
and their accessories.'' ^ For instance, if the reader will shut his 

1 Schafer and Sherrington. See also Munsterberg, Halleck, and other psy- 
chologists. 



APPENDIX 301 

eyes, he can say without looking at his own body, whether or not 
he is sitting in an erect or slouching position, or whether his right 
foot is forward of his left, or vice versa. This knowledge is con- 
veyed by the muscular sense. Similarly, it is the muscular 
sense that enables him to know how much to contract certain 
muscles to correct his position, just as it is the muscular sense 
that enables a baseball pitcher to determine the force and co- 
operation (coordination) of muscular action necessary to throw 
a ball a certain distance in a certain direction to the catcher. 

However instinctive may be the infant's striving for an upright 
position, the gradual achievement of that position from the baby 
who cannot hold up its own head to the Kttle child who stands 
and walks alone, implies a training, not only of the muscles, but 
of a sense of their coordination, and the subconscious sense of 
equilibrium. 

''The muscular sense is no doubt a large contributor toward the 
perception of the mechanical equilibrium of the body, and in that 
way toward the regulation and maintenance of its stability. The 
necessary corrective movements that, during locomotion, prevent 
gravity pulHng us prone, or, as we sit, stand, or maintain postures 
natural to us, involves perception of the relative position of our cor- 
poreal parts, are guided by — one might almost say supplied by — 
the muscular sense. These perceptions, though not for the most part 
' objects ' of attention, determine actions, and can be attended to at 
once, should they arise." ^ 

Note II, Page 221. OVERCORRECTED POSTURE. — That 
exaggerated posture of the ''bantam" type is not a correct 
standing position would scarcely seem to need argument. The 
fundamental requisite of a correct standing position on which 
all authorities are agreed, is that the different parts of the body 
shall be so placed in relation to each other as to require a mini- 

1 Schafer, 159. 



302 



APPENDIX 



mum of muscular effort or strain. The exaggerated lifting of 
the sternum, distention of the ribs, and hyper-extention of the 
spine called for by this exaggerated attitude can only be brought 
about by extreme muscular tension, which cannot be long sus- 
tained. 

To cultivate lordosis through an exaggerated standing position, 
is to cultivate it as an habitual feature when the temporary 
effort of the overcorrected position is relaxed. This is plainly 
shown in the aggravated points of the relaxed fatigue position 
which is the alternative posture of pupils trained for the exag- 
gerated standing position. If the spine alone were involved, 
the fault might not be so serious ; but the mechanical re- 
actions of the body are such that when one part is thus dis- 
placed, other parts change their positions also to maintain the 
equilibrium. As Dr. Lovett says, "An increase of the back- 
ward curve of the spine implies a forward curve or forward dis- 
placement somewhere else to balance it." 

The harm wrought by the lordosis position is comprehensively 
stated by Dr. Goldthwait in the following excerpt describing 
the type of lordosis caused by displacement backward of the 
upper part of the trunk (dorsal spine) : — 

''In this change the pelvis maintains its normal position and rela- 
tion to the legs, but as the upper part of the lumbar spine moves 
backward, as it must in the position of lordosis, the depressions into 
which the posterior viscera rest are consequently deepened, and as 
far as this feature alone is concerned there is less liability of the 
organs becoming displaced downward than is normal. Since, however, 
this feature is only one part of the support of the viscera, and since 
the anterior abdominal wall is of much importance in this support, it 
is evident that as this position necessarily means relaxation of the 
abdominal muscles, a definite portion of the normal support is lost. 

"It is also evident that as in this position the abdominal cavity as 
well as the entire length of the trunk is shortened, the viscera are 



APPENDIX 303 

necessarily crowded downward. In this shortening of the trunk the 
antero-posterior diameter of the abdomen is necessarily increased, 
and with this increase of the diameter the diaphragm must be 
stretched antero-posteriorly, with the result that it becomes flatter 
and the upper part of the dome is lowered. Since at the back the 
diaphragmatic attachment extends down to the last rib, and since 
the liver rests directly against this posterior portion of the dia- 
phragm, if the dome of the diaphragm is flattened, it must result 
in forcing the Hver and stomach forward and downward, lifting 
them out of their normal positions in the spaces at the sides of 
the spine in the curve of the ribs. This naturally results in an in- 
creased pressure upon the kidneys and other viscera, with varying 
degrees of disturbance. 

" With the kidneys the pressure must naturally result in the gradual 
absorption of the retroperitioneal fat upon which they rest, with a 
weakening of this natural support so that even though the depression 
in which the organs rest is deepened, the fat tissue may be so much 
absorbed that together with the lack of tone of Ae abdominal muscles 
an undue mobility may result." ^ 

The objections to purposely cultivating, as a fundamental 
standing or gymnastic position, an exaggerated posture, with its 
hyper-extension of the spine and artificial protrusion of the 
chest, cannot be too strongly stated. It has already been 
pointed out that this overcorrection cultivates lordosis, inter- 
feres with respiration, and tends, in children, to arrest develop- 
ment of the chest. The policy of using such a position for 
corrective purposes, therefore, not only fails of its object, but 
works positive injury. In a somewhat extensive correspondence 
with leading orthopedic surgeons in this country, the author has 
yet to find one who does not condemn this exaggerated position. 
Indeed, many of these practitioners have special methods for 
avoiding any tendency to overcorrection in the execution of 
exercises prescribed for their patients. 

1 Goldthwait, 48. 



304 



APPENDIX 



From a pedagogical standpoint, encouragement of such posi- 
tions is indefensible. The training of the muscular feeHng, or 
muscular sense, of what is right, is one of the great fundamental 
educational elements in this whole question of training correct 
posture ; indeed, it is probably the most important point in the 
entire question. The erect position for a child should always 
be the correct position, no matter for what purpose it is taken. 
To allow him to assume an exaggerated posture for his gymnas- 
tic lesson on the assumption that, by overdoing it then, he will 
relax into the proper position ordinarily, is worse than a ped- 
agogical absurdity, — it is a positive injury to the child. One 
might just as well allow him to overshoot the mark in his arith- 
metic lesson and say that twelve times five are sixty-five, on the 
assumption that he will drop back to the right figures of his own 
volition in after life. In establishing the power and habit of 
good posture with the many thousands of children trained by 
the efficiency methods described in this volume, the principle 
of training the child to discriminate between correct and ex- 
aggerated posture has been sedulously followed. When a 
parent has said, " My boy comes home and says he is being 
taught to stand this way," illustrating a ridiculously overdone 
position, the school in which the faulty teaching occurred has 
been visited and the teacher found whose discrimination on 
these points needed more assistance. In a few instances a 
whole school, through the mistake of a local supervisory official, 
has been characterized by some marked exaggeration in the 
standing position of the children; this has been made a 
matter of thorough and repeated assistance as soon as dis- 
covered. 

There can be no doubt that overcorrection is the easiest way 
of appearing (to the uninitiated) to correct the faults of relaxed 



APPENDIX 305 

posture. It often requires less effort on the teacher's part to 
get overcorrection than accurate positions in the children; 
but accurate teaching is at least as important in physical train- 
ing as in other subjects. It is impossible to avoid all over- 
correction in the first efforts of children to remedy their defects 
of posture ; this is true especially of the youngest children, who 
lack power of muscular adjustment. But such faults should be 
attacked as promptly as any others, and the ideal held before 
both children and teachers should be, always, the correct, and 
not artificial, positions. 

Note 12. HISTORY AND BIBLIOGRAPHY. — The sub- 
ject of posture has been studied from many viewpoints in science, 
art, and education : by the anthropologist, tracing lines of 
evolutionary development ; by the physiaist, seeking to place 
the center of gravity of, and to apply the laws of mechanics to, 
the human body ; by the artist, posing figures for modeling and 
drawing ; by the nerve specialist studying indications of nervous 
states ; by the physical trainer trying to develop to the full the 
physical powers; by the psychologist and actor observing the 
expression of the emotions ; and by the medical practitioner, 
searching for etiological factors in disease. 

The most valuable scientific contributions to the subject have 
been made within comparatively few years. The displace- 
ment of organs, or ptosis, has, perhaps, led to the widest interest 
and study of the subject. In this country the late Dr. J. H. 
Kellogg, of Battle Creek, Mich., first presented the subject 
widely to the medical profession, to popular audiences, and to 
educators. Writing in 1896, Dr. Kellogg said : — 

^'My own attention was called to the importance of the relation 
of these displacements to the general health by the writings of 
GJenard and Pasteur, two eminent French physicians who, twelve or 

X 



3o6 APPENDIX 

fourteen years ago, began to address the profession on this subject. 
Glenard pointed out that with the great majority of persons suffering 
from chronic indigestion, prolapse of the stomach or bowels, or both, 
is the fundamental cause of the disease, and showed that many dys- 
peptics may be cured by the simple application of a bandage for the 
support of the prolapsed organs." 

In 1892 Dr. Eliza M. Mosher, of Brooklyn, presented to the 
medical profession and to educators, studies in the effects of 
posture that attracted wide notice. Dr. Robert W. Lovett 
has placed all students of posture in his debt for the wide 
scholarship and scientific value of his contributions on many 
phases of the subject, made both independently and in 
collaboration. The development of X-ray photography has 
made possible a distinct line of research on the subject of 
ptosis, — research in which Dr. Joel E. Goldthwait and col- 
leagues of Boston have done signal work. Dr. Goldthwait's 
contributions to this and other phases of the scientific study 
of posture are of the highest value. They have been pre- 
sented both in technical and popular form, have attracted 
wide attention, and have given new impetus to the subject. 
From many other sources contributions have been made to 
the studies of the ptoses, their cause and effects. Many of 
these contributions are listed in the Bibliography given in 
the present volume. A very valuable summary of the investi- 
gations, theories, and conclusions of more than a dozen other 
workers — including Stiller, Cseri, Glenard, Faure, Landau, 
Brault, Linder, Kuttner, Laider, Schwerdt, Brlihl, Hagem, Lion, 
Hertz, Voeglsang, Bovier — has been made by Dr. Cumston 
(see Bibliography, 26). 

Parallel with the study of the subject from the viewpoint just 
mentioned, has been the research of orthopedists. Antero- 
posterior deviations of posture have been studied in Germany, 



APPENDIX 307 

chiefly by Langer and Meyer, Staffel, Henke and Boegle, who 
have sought to estabhsh types of variabihty and to determine a 
norm for the erect position. 

The work of these and other men, German, French, and Ital- 
ian, is cited in Lovett, 92, and 86, p. 172. 

In earlier studies of the subject, the spine was the main object 
of attention, but all of the later workers reahze that the entire 
body must be considered in any correction of posture. This 
is especially emphasized by Drs. Lovett, Goldthwait, Mosher, 
(E. M.), and Taylor (H. L.). 

The names of certain workers are associated, though by no 
means exclusively, with studies of different parts of the body 
in relation to posture. Thus, we look to Lovett particularly 
for helpful work on the spine ; to Moshet for the pelvis ; Fitz 
and Goldthwait for the shoulders; Woods-Hutchinson for the 
chest. The foot has been studied by many, though Dr. Henry 
Ling Taylor probably first gave prominence to the importance 
of the straight-foot position. On all phases of posture very 
valuable contributions have been made by others than those 
named. 

The technical student will find the appHed anatomy of pos- 
ture treated in the works of Lovett (86), Goldthwait (47, 48, 
49, 51, 52), Skarstrom (161), and Bowen (145); medical gym- 
nastics in Lovett (86), Taylor (133), McKenzie (98), and Martin 
(97). While the subject of posture is not treated of in Dr. 
Tyler's work on " Growth and Education," no student of 
child development could omit knowledge of that work or of 
Dr. G. Stanley Hall's classic volume on " Adolescence." 

The upholding of standards of posture has been a prominent 
object in the work of physical trainers; and the recognition, by 
educators, of the need for work in this direction has probably had 



3o8 APPENDIX 

more to do with the introduction of physical training into school 
curricula than has appreciation of any other benefit from exercise. 

In the bibhography appended to this volume, no attempt is 
made to give complete references on such related topics as 
scoHosis, fiat foot, or other orthopedic defects, on the general 
growth of children, on school furniture, or on school or personal 
hygiene. On these topics only the more important references 
are given, or those that contain comprehensive summaries, or 
that have a direct bearing on antero-posterior aspects of posture. 

The student of efficiency methods will find especially helpful 
the two books by Mr. Harrington Emerson, Efficiency (164) and 
The Twelve Principles of Efficiency (165), and Mr. Taylor's 
Principles of Scientific Management- (i6g) . These works are not 
only rich with practical help, but their wealth of illustration and 
breadth of vision make them most fascinating reading, while 
their strong humanitarian spirit is an uplift and inspiration. 



% 
BIBLIOGRAPHY 



BIBLIOGRAPHY ON POSTURE, AND RELATED TOPICS i 



I. 



Abbott, Gladys, A Study of Posture in School as Afected by Schoolroom 
Lighting. Am. Phys. Ed. Rev., March, 1905. An effective study of 
facts in the schoolroom. 

2. Allis, Oscar H., Man's Aptitude for Labor in the Erect Position. Trans. 
Col. Phys., Phil., 1887, 3d ser., Vol. IX, p. 35. The center of gravity 
and its method of support in fish, bird, quadruped, and man. Me- 
chanics of, and anatomical adaptations to, the erect position and to 
rotary motion in that position. A most valuable presentation of the 
subject, with ingenious original diagrammatic illustrations. 

3. Baker, Frank, The Ascent of Man. Vice-lresidential Address, Sec- 
tion on Anthropology, Am. Ass. Adv. of Sci., 1890. The most 
valuable summary of the anatomical and physiological disadvantages 
of erect posture, showing that man's adaptation to this position is not 
yet complete and is still going on. 

4. Bancroft, Jessie H., Automatism in Gymnastic Exercise. Am. Phys. 
Ed. Rev., December, 1903. 

5. Barbat, J. H., General Enteroptosis. Calif. State Jour. Med., 1906, 
Vol. IX, p. 291. 

6. Benedict, A. L., Clothing, A Hygienic Heresy. Med. Times, N. Y., 
1908, Vol. XXXV, p. 361. 

7. Blake, Joseph A., What are the End Results of Surgery or Surgical Opera- 
tions for the Relief of Neurasthenic Conditions Associated with the Various 
Visceral Ptoses. Surg., Gynec, an^ Obstet., 1910, Vol. XI, pp. 59-63. 

8. Boston Schoolhouse Commission. Reports on School Furniture, 1901- 
1905. Among the latest and most important studies of the subject. 
See No. 25 of this Bibliography. 

9. Bradford, E. H., The Effect of Recumbency on the Length of the Spine. 
Boston Med. and Surg. Jour., Vol. CIX, p. 245, September, 1883. 

10. Bradford, E. H., Movement of the Front of the Foot in Walking. Jour, 
of the Boston Soc. of Med. Sci., Vol. Ill, 7, p. 205. 

11. Bradford, E. H., Round Shoulders. Trans. Am. Orth. Ass.,Vol. X, 

p. 162. 

1 See Appendix, Note 1 2. 

3" 



312 



BIBLIOGRAPHY 



12. Brad-fo^rd, 'E.B.., Flexion, or Bent-Knee Marching. N. Y. Med. Jour., 
Jan. 27, 1900, p. 109. 

13. Bradford (E. H.) and Lovett (R. W.), A Treatise on Orthopedic 
Surgery. Wm. Wood & Co., N. Y., 1890. Round shoulders, lateral 
curvature, flat foot, etc. 

14. BuLLARD (W. M.) and Brackett (E. G.), Observations on the Steadi- 
ness of the Hand and on Static Equilibrium. Boston Med. and Surg. 
Jour., Vol. II, 1888. 

15. Burke, Frederick, Growth of Children in Height and Weight.. Am. 
Jour, of Psych., April, 1898. One of the most valuable summaries of 
data on growth of children ; large bibliography. 

16. Cabot, Richard C, Physical Diagnosis. Wm. Wood & Co., N. Y., 
1905. Points on chest, spine, and shoulder development. 

17. Chaille, S. E., Infants: Their Chronological Progress. 'New Orleans 
Med. and Surg. Jour., Vol. XIV, 1886-1887, p. 893. 

18. Chamberlain, Alex. F., The Child: A Study in the Evolution of Man. 
Scott, Lond. ; Scribner, N. Y., 1900. Erect posture; growth. 

19. Clark, John G., The Surgical Consideration of Congenital and Develop- 
mental Defects Leading to Obstinate Constipation. Jour. Am. Med. Ass., 
1910, Vol. LV., August 6, p. 449. Discusses relation of posture to en- 
teroptosis. 

20. Clevenger, S. v.. Disadvantages of the Upright Position. The Ameri- 
can Naturalist, Vol. XVIII, January, 1884, No. i. Original study of 
valves in the veins in their relation to the upright posttire in mankind. 
Pathological conditions resulting from their poor adaptation to that 
position. Changes in pelvis and in neck of femur, due to upright 
position. 

21. Clevenger, S. V., Editorial discussion of Dr. Clevenger's article (20), 
Journal of Science, Lond., Vol. VI, 3d ser., March, 1884. 

22. CoDMAN, E. A., Chronic Obstruction of the Duodenum by the Root of the 
Mesentery. Boston Med. and Surg. Jour., April 16, 1908, p. 503- 
Duodenum originally designed for horizontal position, and is disad- 
vantageously placed in vertical position. 

23. Cook, Ansel G., The Question of Balance. An Elementary Study of 
the Balance of the Human Body and the Relation of the Balance of Shoes, 
including Rules for Designing or for Judging the Efficiency of Shoes. 
Am. Jour. Orth. Surg., July, 1907 ; May, 1909. 

24. Cotton, Alfred Cleveland, The Medical Diseases of Infancy and 
Childhood, with Points on the Anatomy, Physiology, and Hygiene Peculiar 
to the Developing Period. J. B. Lippincott Co., Phil, and Lond., 
1906. 

25. Cotton, Frederick J., School Furniture for Boston Schools. Am. 



BIBLIOGRAPHY 313 

Phys. Ed. Rev., December, 1904. This gives in substance Dr. Cotton's 
contributions to the reports of the Boston Schoolhouse Commission 
(see this Bibliog., No. 8), including a valuable digest of previous in- 
vestigations in this country and abroad, and the results of his own 
work, especially on the seat-back. 

26. CuMSTON, Charles Greene, Ptosis of the Abdominal Viscera Surgically 
Considered. Medical Record, Oct. 19, 1907, p. 639. General review 
and history of modern work on the subject of ptoses. 

27. Dane, John, Some Efects upon the Leg of Pronation of the Foot. 
Trans. Am. Orth. Ass., Vol. X. 

28. Darwin, Charles, Expression of the Emotions in Man and Animals. 
Appleton, 1880. 

29. Davis, Edward P., Mother and Child. Lippincott, Phil., 191 1. 

30. Dickinson, Robert L., The Corset: Questions of Pressure and Dis- 
placement. N. Y. Med. Jour., Nov. 5, 1887. 

31. Dickinson, Robert L., Toleration of the Corset: Prescribing where One 
cannot Proscribe. Am. Jour, of Obstet. and Dis. of Women and Ch., 
Vol. LXIII, No. 6, 191 1. An original study, elaborately illustrated. 
Explains simple apparatus, and method for te*ing pressure of corset at 
different points. Gives bibliography on the corset from 1908 to date. 

32. Donaldson, H. H., The Growth of the Brain. Walter Scott, Lond.; 
Scribner, N. Y., 1895. Proportionate growth of body and viscera. 

T,T,. DuNLOP, John, Relaxation of the Sacra-iliac Synchondroses. N. Y- 
Med. Jour., Dec. 8, 1906. 

34. DtiNLOP, John, Further Studies of the Relaxation of the Sacro-iliac 
Synchondroses. Am. Jour. Orth. Surg., July, 1907. 

35. 'EjIAAS,Hkvei.oc^, Man and Woman. Scott, Lond. ; Scribner, N. Y., 
1904. Erect posture. Growth and proportions. 

36. Evans (W. A.) and McHugh (M. G.), The Shape of the Chest in Some 
Thoracic Conditions, and Especially in Tuberculosis. Medical Examiner 
and Practitioner, October, 1902. 

37.. Feiss, Henry O., The Mechanics of Lateral Curvature. First Paper: 
"The Mechanical Tendencies of Posture in the Normal." Am. Jour. 
Orth. Surg., Vol. IV, pp. 1-37, July, 1906; other papers, April, 1907; 
October, 1907 ; January, 1908. An elaborate and valuable contribution 
to the subject. Illustrated. 

38. FiTTEROLF (George) and Gittings (J. Claxton), Some Anatomical 
Features of the Child's Thorax and their Practical Application in Phys- 
ical Diagnosis. Am. Jour, of Dis. of Ch., Vol. I, 191 1. 

39. FiTZ, George Wells, Bed Posture as an Etiological Factor in Spinal 
Curvature. Trans. Am, Orth. Ass., 1898. Report of original study. 
Illustrated. 



314 



BIBLIOGRAPHY 



40. FiTZ, George Wells, A Clinical and Anatomical Study of Resistant 
Forward Shoulders. Boston Med. and Surg. Jour., April 19, 1906. A 
very valuable original study. 

41. Forbes, A. Mackenzie, Internal and External Atony. Am. Phys. Ed. 
Rev., June, 191 2. 

42. FoTHERGiLL, J. MiLNER, The Diseases of Sedentary and Advanced Life. 
London: BaUiere, Tindall and Cox, 1885. Chest development as a 
factor in lung development. Recommends swings for children for 
effect on lungs. 

43. FoTHERGiLL, W. E., Some Remarks on Corsets. Med. Press and Circ, 
July 8, 1903. Favors right kind of corset if not worn tight. 

44. Galbraith, Anna M., Personal Hygiene and Physical Training for 
Women. Saunders, Pub., Phil, and Lond., 191 1. 

45. GiBNEY, Virgil P., Contribution in Vol. II of System of Surgery. 
Edited by Dennis, F. T. ; Lea Bros. & Co., Phil., 1905. Flat foot, 
lateral curvature, etc. 

46. GiHON, A. L., Physical Measurements, in Wood's Reference Hand Book 
of the Medical Sciences, Vol. V, pp. 667-673. 

47. Goldthwait, Joel E., The Importance of the Pelvic Joints in the Mainte- 
nance of the Correct Poise of the Body. Am. Phys. Ed. Rev., June, 1909. 

48. Goldthwait, Joel E., The Relation of Posture to Human Efficiency 
and the Influence of Poise upon the Support and Function of the Viscera. 
Boston Med. and Surg. Jour., Dec. 9, 1909. Indispensable to the tech- 
nical worker and adapted also to popular reading. 

49. Goldthwait (Joel E.) and Brown (Lloyd T.), The Cause of Gastrop- 
tqsis and Enter ptosis, with their Possible Importance as a Causative 
Factor in the Rheumatoid Diseases. Boston Med. and Surg. Jour., 
Vol. CLXII, No. 21, pp. 695-703, May 26, 19 10. Of great importance 
for the technical worker. 

50. Goldthwait (Joel E.) and Brown (Lloyd T.), The Recognition of 
Congenital Visceral Ptosis in the Treatment of the Badly Poised and 
Poorly Nourished Child. Am. Jour. Orth. Surg., November, 191 1. 

51. Goldthwait, Joel E., An Anatomic and Mechanical Study of the 
Shoulder -joint, Explaining many of the Cases of Painful Shoulder, many 
of the Recurrent Dislocations, and many of the cases of Brachial Neuralgias 
or Neuritis. Am. Jour. Orth. Surg., May, 1909. One of the most 
important studies of the shoulder. 

52. Goldthwait (J. E.) and Osgood (R. B.),^ Consideration of the Pelvic 
Articulations from an Anatomical, Pathological, and Clinical Standpoint. 
Boston Med. and Surg. Jour., June and July, 1905, p. 593. 

53. Goldthwait, Joel E., A Consideration of the Round or Stoop-Shoulder 
Deformity. Am. Jour. Orth. Surg.. April, 1908. 



BIBLIOGRAPHY 315 

54. GoLDTHWAiT, JoEL E., A Consideration of the ''Round Shoulder'' or 
"Stoop Shoulder'' Deformity in Childhood, with Especial Reference to 
the Proper Adjustment of the Clothing in Preventing and Treating Such 
Conditions. Am. Jour. Orth. Surg., Vol. I, p. 64, 1903-1904. 

55. Hall, G. Stanley, Adolescence. Appleton, 191 1. 

56. Hall, G. Stanley, Youth: its Education, Regimen, and Hygiene. Apple- 
ton, 1 907 . A condensation of the larger work on A dolescence. Assump- 
tion and significance of erect posture. 

57. Hall, Winfield S., The Changes in the Proportions of the Human Body 
during the Period of Growth. Jour. Anthrop. Inst, of Great Britain 
and Ireland, 1895-1896, Vol. XXV. 

58. Halleck, Reuben Post, Education of the Central Nervous System. 
Macmillan, N. Y., 1899. 

59. Halleck, Reuben Post, Psychology and Psychic Culture. Macmillan, 
N. Y., 1900. Emotional expression and inhibition. 

60. Hare, Samuel, Facts and Observations on the Physical Education of 
Children, especially as Regards the Prevention of Spinal and Other De- 
formities. J. Churchill, Lond., 1852. 

61. Hartwell, Edward Mussey. School Furf^ture. Report of the 
Director of Physical Training, Boston. School Document, Nov. 4, 
1895. A very valuable study of the subject, giving digest of foreign 
and other investigations. 

62. Harvey, F. W., Gymnastic Treatment of Diastasis of the Recti abdomi- 
nales. Am. Phys. Ed. Rev., June, 191 2. 

63. Hastings, Wm. W., .4 Manual of Physical Measurements, 1902. Bas- 
sett and Co., Springfield, Mass. Measurements at different ages. 

64. Herz, M., Interference with Heart Action by Stooping. Theropie der 
Gegenwart, June, 1908, No. 6, p. 241. 

65. HoAG, Ernest Bryant, The Health Index of Children. Whitaker and 
Ray-Wiggin Co., San Francisco, 1910. A chapter on general hygiene 
of erect posture and one on the foot. 

66. Holt, L. Emmett, The Diseases of Infancy and Childhood. Appleton, 
N. Y., 191 1. Relative chest circumference at different ages. Changes 
in chest proportions with growth. Ontogenetic acquirement of erect 
position. 

67. Hutchinson, Jonathan, The Thorax. Article in Todd's Cyclopedia 
of Anatomy and Physiology. Longmans, Lond., 1859. 

68. Hutchinson, Woods-, Some Deformities of the Chest in the Light of its 
Ancestry and Growth. Jour. Am. Med. Ass., September, 1897. All of 
Dr. Woods-Hutchinson's articles are indispensable to the technical 
student of posture. 

69. Hutchinson, Woods-, Is the Consumptive Chest Flat ? Jour. Am. Med. 
Ass., May 2, 1903, p. 1196. A very important article. 



3i6 BIBLIOGRAPHY 

70. Hutchinson, Woods-, The Form of the Chest in Phthisis and its Sig- 
nificance. British Med. Jour., Oct. 28, 1899. 

71. Hutchinson, Woods-, Studies in Human and Comparative Pathology. 
H. J. Glaisher, Lond., 1901. 

72. Hutchinson, Woods-, Foot Faults. Good Housekeeping, July, August, 
191 2. Two popular and very interesting articles on the foot, its use 
and hygiene. 

73. Jackson, J., Handwriting in Relation to Hygiene. Seventh Int. Cong. 
Hyg. and Dem.. Lond., 1891, Vol. 4. 

74. Jaeger, Gustav, Problems of Nature. Williams and Norgate, London, 
1897. Biological development of the human foot. Effect on infant's 
foot of learning to stand and walk. Biological explanation of upright 
posture. Growth of certain bones produced by increased use and 
exercise due to erect posture. Relative length of legs and trunk ; the 
part supporting grows relatively faster than the part supported. 
Relation of size of vertebrae to weight bearing and to exercise of the 
arms. Changes during growth in chest proportions and position of 
scapulae due to erect posture. 

75. James, William, Psychology. Henry Holt and Co. Relation of emo- 
tions to posture. 

76. Johnson, George E., Psychology and Pedagogy of Feehle-Minded 
Children. Ped. Sem., October, 1895. 

77. Kellogg, J. H., Experimental Researches : Relation of Dress to Pelvic 
Diseases of Women. Tr. Mich. State Med. Soc, 1888. 

78. Kellogg, J. H., Outline Views of the Human Figure. Battle Creek, 
1898. 

79. Kellogg, J. H., The Influence of Dress in Producing the Physical De- 
cadence of American Women. Jour. Mich. State Med. Soc, 1891. 

80. Kellogg, J. H., The Relation of Static Disturbances of the Abdominal 
Viscera to Displacement of the Pelvic Organs. Proc. Internat. Congress, 
Gynec. and Obstet., 1892. 

81. Kellogg, J. H., Physical Deterioration Resulting from School Life. 
N. E. A. Report, 1896, p. 899. A very helpful and important article 
for both popular and technical readers. 

82. Lagrange, Fernand, Physiology of Bodily Exercise. Appleton, 1890. 
Exercise and respiration. Automatism in exercise. 

83. Lane, W. Arbuthnot, Some of the Laws which Influence the Growth of 
Children. Trans. Seventh Int. Cong. Hyg. and Dem., Lond., 1891, 
Vol. IV, p. 103. 

84. Lane, W. Arbuthnot, Civilization in Relation to the Abdominal Viscera, 
with Remarks on the Corset. Lancet, Lond.. Nov. 13, 1909, pp. 1416- 
1418. 



BIBLIOGRAPHY 317 

85. Lister, Sir J., An Address on the Influence of Position upon Local Cir- 
culation. British Med. Jour., London, 1879. 

86. LovETT, R. W., Lateral Curvature of the Spine and Round Shoulders. 
P. Blakiston's Son & Co., 1012 Walnut St., Phil. 2d ed., 1Q12. 
Indispensable to the technical worker. One of the classics on the 
subject. 

87. LovETT (R. W.) and Reynolds (E.), Method of Determining the Posi- 
tion of the Center of Gravity in its Relation to Certain Bony Landmarks 
in the Erect Position. Am. Jour, of Physiol., May i, 1909. 

88. LovETT, R. W., The Treatment of Round Shoulders by Forcible Correc- 
tion. Am. Jour. Orth. Surg., Vol. II, p. 200. 

89. LovETT, Davis, and Montgomery, Arch, di Ortopedia, 1906, Vols. V 
and VI, p. 372. Study of curves at different ages. 

90. LovETT, R. W. See also Bradford and Reynolds. 

91. LovETT, Robert W., The Mechanism of the Normal Spine and its Rela- 
tion to Scoliosis. Boston Med. and Surg. Jour., Sept. 28, 1905, pp. 
349-358, June 4, 1900; Oct. 31, 1901, March 17, 1904; and in Am. 
Jour, of Anat., Vol. II, pp. 4, 457. 

92. Lovett, Robert W., Round Shoulders and ^ulty Attitude. Boston 
Med. and Surg. Jour., Nov. 6, 1902. Reprinted in Am. Phys. Ed. Rev., 
December, 1902. 

93. Lovett, R. W. Discussion of Pronation of Foot in Standing Position 
and its Association with Faulty Attitude. Trans. Am. Orth. Ass., Vol. 
X. 

94. Manaceine, Marie de. Sleep; its Physiology, Pathology, Hygiene, and 
Psychology. Walter Scott, London; Scribner, N. Y., 1897. Sleeping 
positions, etc. 

95. Marey, E. J., Animal Mechanism. A Treatise on Terrestrial and 
Aeria,! Locomotion. Appleton ; Int. Sc. Ser. 

96. Martin, Franklin H., Visceral Prolapse. Surg,, Gynec, and Obstet., 
December, 1908. 

97. Martin, Franklin H., Gymnastic and other Mechanical Means in the 
Treatment of Visceral Prolapse and its Complications. Surg., Gynec, 

.and Obstet., August, 191 2. Of especial value to the medical gymnast. 
Illustrated. 

98. McKenzie, R. Tait, Exercise in Education and Medicine. W. B. Saun- 
ders Co., Phil, 191 1. Exercises for lateral curvature and flat foot. 
Anatomy of movements of spine. 

99. Mosher, Eliza M., The Influence of Habitual Posture on the Symmetry 
and Health of the Body. Brooklyn, Med. Jour., July, 1892. An original 
study. Discussion by several physicians, including Dr. W. F. Dudley, 
who spoke of asymmetrical posture as a probable cause of obstructed 



31 8 BIBLIOGRAPHY 

nasal breathing and other defects of function and structure in nose and 
throat. 

loo. MosHER, Eliza M., Habitual Postures oj School Children. Educational 
Review, November, 1892. 

loi. MosHER, Eliza M., Habits of Posture a Cause of Deformity and Dis- 
placement. N. Y. Jour, of Gynec. and Obstet., November, 1893. 

102. MosHER, Eliza M., Health and Happiness; a Message for Girls. 
Funk & Wagnalls, N. Y., 191 2. An important book in which hygiene 
for girls is based on correct posture. Sex education. 

103. MuMEORD, A. A., Survival Movements of Human Infancy. Brain, Vol. 
XX, p. 290. 

104. MuNRO, Prehistoric Problems. Chapter II, "On the Influence of the 
Erect Position." Presidential address in Anthropology at Brit. Ass. 
at Nottingham, 1893. 

105. MuYBRiDGE, E., The Human Figure in Motion. Chapman Hall, 
Lond, 

106. OcHSNER, Edward H., Potential and Acquired Static Flat Foot. Jour. 
Am. Med. Ass., Nov. 23, 1907. Observation on causes of flat foot, 
its hygiene, etc. 

107. O'FoLLOWELL, Le Corset. 2 vols. Maloine, Paris, 1908. Elaborately 
illustrated; gives full bibliography to date. 

108. Oppenheim, Nathan, The Development of the Child. Macmillan, 1902. 
Facts in comparative development. 

109. Osborne, Jonathan, On Some Actions Performed by Voluntary 
Muscles which by Habit become Involuntary. Dublin Quar. Jour. Med. 
Sci., 1859, Vol. XXVIII, p. 120. Orignial study of sleeping positions. 
Comments on erect position. 

no. Pettigrew, J. B., Animal Locomotion ; or Walking, Swimming, and 
Flying. Appleton, Int. Sci. Ser. 

111. Polk, W. M., The End Results of Surgical Operations for the Relief of 
Neurasthenia Associated with the Various Visceral Ptoses. Surg., 
Gynec, and Obstet., 1910, XI, pp. 476-479. 

112. Pyle, Walter L., A Manual of Personal Hygiene. W. B. Saunders 
Co., Phil, and Lond., 191 2. Chapter on erect posture by Goldthwait. 
Hygiene of the foot. 

113. Rankin, F. H., Hygiene of Childhood. D. Appleton & Co., N. Y., 
1890, 

114. Reynolds, Edward, The Etiology of the Ptoses and their Relation to 
Neurasthenia. Jour. Am. Med. Ass., 1910, Vol. LV, pp. 1943-1949. An 
important article for the technical student. 

115. Reynolds (Edward) and Lovett (Robert W.), An Experimental 
Study of Certain Phases of Chronic Backache. A Combined Gynecologic 



BIBLIOGRAPHY 319 

and Orthopedic Investigation. Illustrated. Jour. Am. Med. Ass. 
March 26, 1910. Posture in relation to corsets and high heels. Good 
and bad corsets. Balance for determining center of gravity. 

116. RiBOT, Th., The Psychology of the Emotions. Scribner, 1906. 

117. Ross, James, Diseases of the Nervous System. Wm. Wood & Co. 
N. Y., 1883. Function of cerebro- and cerebello-spinal systems in 
erect posture, walking, etc. 

118. ^OTCii,T.M., Pediatrics. Lippincott, Phil., 1903. Surface anatomy 
of spine. Natural development of antero-posterior curves. Propor- 
tionate length of above at different ages from Rasenal, Aeby, Dwight, 
Symington. Chest index — from Dwight and Symington. Natural 
changes in arch of foot. Hygiene of foot. Ontogenetic development 
of erect position. 

119. Roth, Bernard, The Nomenclature of Spinal Deformities. Lancet, 
Lond., 191 1, Vol. II, p. 969. 

120. Roth, Bernard, Treatment of Lateral Curvature of the Spine. H. K. 
Lewis, Lond., 1899. Antero-posterior curves and their relation to lat- 
eral curves. Flat foot. 

121. Roth, Matthias, The Prevention and Cure 0^ Many Chronic Diseases 
by Movements. John Churchill, Lond., 1851. Standing, walking, lying. 

122. Sargent, Dudley A., Physical Education. Ginn & Co., Boston and 
N. Y., 1906. Need of training correct posture during growing years ; 
relation to school life ; proportionate growth of body, etc. 

123. Sayre, Lewis A., Orthopedic Surgery and Diseases of the Joints. 
Appleton, 1876. 

124. Schneider, F. C. E., Those Little Postural Defects. Mind and Body, 
February, 191 2. 

125. Scudder, Charles L., Seating of Pupils in the Public Schools. Boston 
School Document, No. 9, 1892. 

126. Shaw, Edward, R., School Hygiene. Macmillan, N. Y., 1901, Im- 
portant chapters on school furniture and posture in relation to this and 
to school life. 

127. Sherrington, C. S., Chapter on "The Muscular Sense," in Schafer's 
Text Book on Physiology. Special appHcation to the erect position. 
An important study. 

128. Smith, Rae, Intestinal Indigestion from a Surgical Point of View. 
Calif. State Jour. Med., 191 1, Vol. IX, pp. 315-320. Considers rela- 
tion of ptosis to indigestion. 

129. Stecher, William A., An Inquiry into the Problem of Desks for School 
Children. Mind and Body, April, 191 1. Read before the Am. Sch. 
Hyg. Ass., 191 1. An extensive original study for standardizing the 
heights of unadjustable school furniture in different grades. 



320 



BIBLIOGRAPHY 



130. Stillman, Charles F., Round Shoulders. Trans. Am. Orth. Ass., 
Vol. I, 1889. Discusses in general terms backward yielding of the 
spine. 

131. Symington, Johnson, Notes on the Efect of Tight Lacing upon the 
Position of the Abdominal Viscera. Edin. Med. Jour., 1891, Vol. 
XXXVI, p. 616. 

132. Taylor, Henry Ling, The Foot in Gymnastics. Am. Phys. Educ. 
Rev., December, 1902. 

133. Taylor, Henry Ling, Or//fo^g^ic .Swr^ery. Apple ton, 1 910. Besides 
treating of the usual anterorposterior deviations, this book describes 
and illustrates the various deformities which are likely to be encountered 
in any physical examination of large numbers of children; of great 
value to the technical worker, 

134. Taylor, John Madison, Physical Culture in Children. The Objects 
to be Attained. Pediatrics, Vol. XII, No. 7, 1901. Discusses erect 
posture. 

135. Taylor, John Madison, Remarks on the Treatment of the Visceral 
Ptoses. Phil. Med. Jour., Jan. 10, 1903. 

136. TowNE, Lillian M., A Preliminary Study of PupiW Attitudes. Am. 
Phys. Ed. Rev., March, 1901. 

137. TowNE, Lillian M., ^4 Continued Study of Pupils^ Attitudes. Am. 
Phys. Ed. Rev., March, 1902. 

138. Trettien, August W., Creeping and Walking. Am. Jour, of Psych., 
October, 1900. A valuable original study of infant chest development, 
position of scapulae, and the physical and psychological elements in- 
volved in assuming the erect position and early locomotion. Hygiene 
of acquiring erect posture. Sleeping positions. Relative proportions 
of body. Early movements. 

139. Turner, Sir William, Some Distinctive Characters of Human Struc- 
ture. Report of Brit. Ass. for Adv. of Sci., 1897. With special rela- 
tion to the erect attitude. 

140. Tyler, John Mason, Growth and Education. Houghton, MifHin & 
Co., 1907. A very important work for both popular and technical 
use. Significance of bodily growth and proportions and their relation 
to education. 

141. Uffelmann, Julius, Manual of the Domestic Hygiene of the Child. 
G. P. Putnam's Sons, N. Y. and Lond., 1891. Relation of chest 
circumference to body length at different ages. Development of phys- 
iological curves of spine. Sleeping positions. 

142. Warner, Francis, Physical Expression. Appleton, 1893. A study 
of the element of expression in various postures. 

143. Whitman, Royal, A Treatise on Orthopedic Surgery. Lea & Febiger, 



BIBLIOGRAPHY 321 

N. Y. and Phil., 1910. Antero-posterior curves and their exaggera- 
tions. The foot, its structure, action, and hygiene. Proper chest 
proportions. 
144. Williams, William, Some Remarks on Chlorosis. Med. Press and 
Circ, Vol. 75, June 24, 1903. Relation of tight dressing to anaemia in 
early adolescence. 



II 

WORKS CONSULTED ON ANATOMY. PURE AND APPLIED, 

AND ON PHYSIOLOGY 

145. BowEN, Wilbur P., The Mechanics of Bodily Exercise. Published by 
author. State Normal College, Ypsilanti, Mich., 1909. Anatomy and 
action of joints and muscles. Chapter on posture. 

146. Braune* and Bellamy, Topographical Anatomy. 

147. Cunningham, D. J., Lumbar Curve in Man arM the Apes. Cunning- 
ham Memoirs, No. II; Proc. Royal Irish Acad., Dublin. Also in 
Nature, Vol. XXXIII, p. 378, 1886. 

148. Cunningham, D. J., Text Book of Anatomy. Wm. Wood & Sons, N. Y. 

149. D wight, Thomas, Frozen Sections of a Child. Wm. Wood & Co., 
N. Y., 1881. 

150. Foster, M., A Text-Book of Physiology. Macmillan, 1904. 

151. Gerrish, F. H., Textbook of Anatomy. By American authors; Lea 
Bros., Phil, and N. Y., 1902. 

152. Gray, Henry, Anatomy, Descriptive and Surgical. Lea & Febiger, 
Phil, 1908. 

153. Huxley, Thomas H., Lessons in Elementary Physiology. Macmillan, 
191 2. The erect position and how maintained. 

154. Luciani, Luigi, Human Physiology. Macmillan, 191 1. 

155. Martin, H. Newell, The Human Body. Henry Holt & Co., N. Y. 

156. Morris, Henry, A Treatise on Human Anatomy. J. and A. Churchill, 
Lond., 1902. 

157. PiERSOL, George A., Human Anatomy. Lippincott, Phil., 1907. 

158. Quain's Anatomy. Edited by Schafer and Thane. Longmans, 
Green, & Co., Lond. and N. Y., 1894. Vol. II, Pt. II, pp. 161-162. 
Effect of antero-posterior curve of spine on ribs. Effect of obliquity 
of ribs in respiratory movements. 

159. Schafer, E. A., Text Book of Physiology. Pentland, Edinborough, and 
Lond., 1900. Center of gravity in human body. Review of investi- 



322 



BIBLIOGRAPHY 



gations to 1900. Mechanics of different positions and activities, in- 
cluding erect posture and walking. The effect of posture on the 
circulation. 

160. Seaver, Jay W., Anthropometry and Physical Examination. Pub- 
lished by the author, New Haven, Conn. 

161. Skarstrom, William, Gymnastic Kinesiology ; a Manual of the Mecha- 
nism of Gymnastic Movements. F. A. Bassett and Co., Springfield, Mass., 
1909. A very helpful work in applied anatomy. Discusses the mus- 
cular action in various types of poor posture and their correction. 

162. ViERORDT, H., Daten und Tabullen. Jena, 1906. 



Ill 

BIBLIOGRAPHY ON EFFICIENCY METHODS AND SCIENTIFIC 

MANAGEMENT 

163. Carpenter, Charles W., Profit-making Management. Published by 
Engineering Magazine, N. Y. 

164. Emerson, Harrington, Efficiency as a Basis for Operation and Wages. 
The Engineering Magazine, Pub., N. Y., 3d ed., revised and enlarged, 
1912. One of the classics on the subject. 

165. Emerson, Harrington, The Twelve Principles of Efficiency. The 
Engineering Magazine, Pub., 191 2. A book of fundamental impor- 
tance. 

166. GiLBRETH, Frank B., Motion Study: a Method for Increasing the Effi- 
ciency of Workmen. D. van Nostrand Co., N. Y., 191 1. 

167. Gillette and Dana, Cost Keeping. Published by Engineering 
Magazine., N. Y. 

168. Grant, Work, Wages, and Profit. Published by Engineering Magazine, 
N. Y. 

169. Taylor, Frederick Winslow, The Principles of Scientific Manage- 
ment. Harper & Bros., Pub., N. Y. and Lond., 1911. One of the 
very important books on the subject. 

170. Taylor, Frederick Winslow, Shop Management. Harper & Bros., 
1912. 



% 

INDEX 



INDEX 



Abbott, Gladys, 261. 

Abdomen, S3, 96-97; exercise for, 141; 

contours of, 171, 292. 
Acquirement of erect position, i, 151. 
Adults, posture of, 14, 102-108. 
Advantages of erect position, 4. 
Allis, Oscar H., 5. 
Antero-posterior curves of spine. See 

Spinal column. 
Automatism in exercise, 232. 

Bad posture. See Faulty posture. 

Baker, Frank, 4, 57, 283. 

Balance for determining center of 

gravity, 19, 20. 
"Bantam attitude." See Exaggerated 

posture. 
Books, carrying of, 162, 262. 
Boston school furniture, 256-257. 
Bowen, Wilbur P., 307. 
Brain development and erect position, 

5, 275. 
Burke, Frederick, 21. 

Center of gravity in body, 19-23, 291. 

Cerebral development and erect posi- 
tion, 5. 

Chaille, S. E., 74. 

Chairs, 112, 156. 

Change of position, 2, 11 7-1 18, 259. 

Chest, 61-76, 293 ; exercise for, 67, 146 ; 
index, 65-67 ; measurements, 74-76, 
105, 293. 

Circulation of the blood and erect pos- 
ture, 4, 283. 

Clevenger, S. V., 4, 283. 

Clothing and posture, 167-177, 267. 

Cook, Ansel G., 175. 

Corrective exercise explained, 132, 228. 

Corsets, 170-175, 296-298. 

Cotton, Alfred Cleveland, 34, 152. 

Cotton, Frederick J., 255. 



Credits for physical training, 184-186, 

200, 204, 239. 
Cunningham, D. J., 34. 

Dancing, 146, 176, 229, 237. 

Darwin, Charles, 276. 

Defective brain development and pos- 

^ ture, 5, 275. 
Dickinson, Robert L., 170, 286, 297-298. 
Disadvantages of erect position, 4, 283. 
Donaldson, H. H., 32. 
Dress and posture, 167-177, 267. 
Dwight, '^omas, 52, 62, 65, 294-295. 

Efhciency methods, 178-241; summary 

of, 23S, 308. 
Ellis, Havelock, 4. 
Emerson, Harrington, 308. 
Emotion expressed by posture, 275. 
Erect position, acquirement of, i, 151; 

reasons for, 2. 
Evans (W. A.) and McHugh (M. G.), 

65. 
Exaggerated posture, 12, 31-33, 72-73- 

126, 130, 221. 
Exercise and posture, 37, 76, 132-148, 

227-237, 242, 301. 

Fatigue position, 10. 

Faulty posture, 10-15; effect on trunk 

capacity, 38-44 ; effect on height, 41- 

42 ; classification of, 290. 
Feet, 97-101 ; exercise for, 145 ; dress 

of, 175-177- 
Feiss, Henry O., 16, s~- 
Fitterolf (George) and Gittings (J. 

Claxton), 52, 62. 
Fitz, George Wells, 86, 154, 307 ■ 
Forbes, A. MacKenzie, 42. 
Fothergill, W. E., 174- 
Furniture for home, 156; for school, 

255- 



325 



326 



INDEX 



Galbraith, Anna M., 170, 175, 298. 

Gerrish, F. H., 296. 

Goldthwait, Joel E., 33, 41, 42, 49, 57, 
81, 83, 86, 92, 106, 169, 286, 302- 
303, 306-307. 

Gravitation, relation to erect posture, 24. 

Gravity, center of, in body, 19, 20, 21, 
23, 287-288, 291. 

Gray, Henry, 52, 62, 293. 

Grouping and group teaching for pos- 
ture, 197, 238. 

Hale, Nathan, 279. 

Hall, G. Stanley, 62, 63, 73, 74, 154, 292, 

307- 
Hall, W. S., 74. 
Halleck, Ruben Post, 300. 
Hartwell, Edward Mussey, 255. 
Harvey, F. W., 97. 
Hastings, Wm. W., 21, 295. 
Head, 52-58; correcting posture of, 127, 

138, 220, 293. 
Height and posture, 9, 41-42. 
Herz, M., 42. 
High heels, 176-177, 299. 
History and bibliography, 305. 
Holt, L. Emmett, 62, 152, 175. 
Hutchinson, Woods-, 62, 64, 65, 67, 73, 

79, 80, 88, 113, 147, 175, 294. 
Huxley, Thomas H., 5, 16. 
Hygiene of posture, at home, 151-164; 

dress, 167-177; school, 253-267. 

Jaeger, Gustav, 62, 175. • 
James, WiUiam, 277. 
Johnson, George, E., 5, 275. 

Kellogg, J. H., 42, 71, 72, III, 170, 305. 
Kyphosis, 32. See Spinal column. 

Lateral curvature of the spine. See 

Spinal column. 
Lincoln, 38, 279. 
Lordosis, 32, 302-303. 
Lovett, R. W., 4, 16, 19, 32, 34, 81, 122, 

169, 284, 288-289, 290, 292, 302, 306- 

307- 
Lovett, Davis, and Montgomery, 34. 
Lunches, school, 265. 

Manaceine, Marie de, 156. 
Marey, E. J., 114. 



Martin, F. H., 42, 307. 
McKenzie, R. Tait, 146, 307. 
Mechanics of erect position, 2, 4, 16-24, 

32. 
Mental defectives and erect posture, 5, 

275- 
Morris, Henry, 296. 
Mosher, Eliza M., 48, 50, 96, 113, 170, 

262, 298, 306-307. 
Motivation of pupil's work, 187, 299. 
Miinsterberg, Hugo, 300. 
Muscular coordination, 229-231. 
Muscular sense, 122, 214, 271, 300. 
Music practice, 163. 

Ochsner, Edward H., 100, 146. 
Old age, posture in, i, 28. 
Oppenheim, Nathan, 62. 
Osborne, Jonathan, 156. 
Overcorrected posture. See Exaggerated 
posture. 

Pathological cases, 13, 47-51, 85, 98, 213. 

See Tuberculosis. 
Pelvis, 30, 34, 92-96, III, 285, 290. 
Pettigrew, J. B., 114. 
Piersol, George A., 52, 62, 65, 68, 295. 
Posture drill, 128, 223. 
Ptoses, from poor posture, 42-44, 57-58. 
Pyle, Walter L., 175, 

Ratings for posture. See Credits. 
Reasons for erect posture, 2. 
Resistant forward shoulders, 85-89. 
Respiration, effect of posture on, 68, 71, 

73 ; exercise for, 76, 144. 
Response exercise, 231. 
Reynolds (Edward) and Lovett (Robert 

W.), 19, 20, 170, 175, 291, 296, 298. 
Rhythmic exercise, 232. 
Ribot, Th., 277. 
Ribs, obliquity of, 68, 295 ; correction 

of, over distention, 126. 
Ross, James, 5, 16, 275. 
Rotch, T. M., 34, 62, 100, 146, 152, 175, 

176. 

Sargent, Dudley A., 24, 62, 73, 253, 295. 

Scapulae. See Shoulders. 

Scapulce alatce, 82, 220. 

Schafer, E. A., 16, 23, 114, 292, 300-301. 

Scoliosis. See Spinal column. 



INDEX 



327 



Scudder, Charles L., 255, 

Seguin, 275. 

Shaw, Edward R., 255. 

Sherrington, C. S., 300. 

Shoulders, 79-91 ; to correct position of, 
127, 136-138, 220, 259. 

Sitting positions, 11, 111-112, 254-260. 

Skarstrom, William, 307. 

Sleeping positions, 154. 

Spinal column, antero-posterior curves, 
etc., 27-44; lateral curves, 13-15, 
47-51 ; limibar curve, 29, 30, 31 ; 
cervical curve, 28, 30, 55 ; dorsal 
curve, 28, 30, 31, 32, 35 ; to correct 
position of , 125, 140, 214. 

Stair climbing, 11 5-1 17. 

Standing positions, 107, 112-113, 261. 

Statistics of posture, 14, 212. 

Stecher, William A., 255. 

Sternum, 52, 71, 105-106, 295. 

Straight-back position, 11. 

Taylor, Frederick Winslow, 308. 
Taylor, Henry Ling, 100, 146, 175, 307. 



Training for erect posture, age for be- 
ginning, 36-37. 
Trettien, August W., 5, 62, 81, 88, 152, 

275- 
Triple test for posture, 197, 238. 
Trunk capacity, importance of, 38. 
Tuberculosis, 63-65, 72, 80. 
Tyler, John Mason, 38, 62, 63, 65, 67, 

74, 295, 307- 

Veins, relation of, to erect posture, 4, 283. 
Vertical line test for posture, 6, 283. 
Vierordt, H., 44, 57. 

Walking, 24, 113-115. 
Washington, 38. 

Waste of energy in poor posture, 2. 
Weight carrying, 161, 262-265. 
Whitman, Royal, 62, 65, 98, 175. 
Williams, William, 174. 
Wilson, H. B., 299. 

Wing shoulder blades. See S cap nice. 
alatcB. 



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